A rare variant of Guillain-Barre syndrome: Isolated bilateral facial paralysis

Objectives: This study aimed to investigate the frequency and characteristics of a rare variant of Guillain-Barre syndrome (GBS), isolated bilateral facial paralysis (iBFP), and the impact of the COVID-19 (coronavirus disease 2019) pandemic on the frequency of GBS and iBFP. Patients and methods: This retrospective study reviewed 1,986 patients who were hospitalized, followed up, and treated between March 11, 2020, and August 11, 2023, and included 32 patients (22 males, 10 females; mean age: 51.6[+ or -]19.3 years; range, 18 to 87 years) diagnosed with GBS in the analyses. Additionally, information was obtained from hospital records regarding admission dates, length of stay, age, sex, and diagnoses of patients admitted between January 1, 2019, and March 11, 2020, and five patients diagnosed with GBP were identified during this period. Results: Eleven patients presented with facial paralysis, and iBFP was observed in five (15.6%) of them (4 males, 1 female). In iBFP patients, albuminocytological dissociation was detected in three cases, and the anti-GD1b IgG antibody was detected in one case. Electromyography findings of iBFP patients showed bilateral facial nerve involvement in only two cases, bilateral facial nerve involvement along with multiple A waves in other peripheral motor nerves in two cases, and facial nerve involvement along with AIDP findings in one case. The incidence of GBS was notably higher compared to the 15-month period before the COVID-19 pandemic (0.29% vs. 1.6%). Conclusion: The frequency of iBFP was found to be higher than expected in our inpatient GBS patient group. It was noted that these patients were not associated with a specific anti-ganglioside antibody and had a good prognosis. Keywords: COVID-19, facial diplegia with paresthesia, Guillain-Barre syndrome variants, peripheral facial paralysis.