Reversible cerebral vasoconstriction syndrome in Guillain-Barre syndrome: a case report and literature review

Neurol Sci. 2024 Jan;45(1):101-107. doi: 10.1007/s10072-023-07061-8. Epub 2023 Sep 7.

Abstract

Background: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by transient constriction of cerebral arteries, leading to severe headache and potential complications. The association between RCVS and Guillain-Barre syndrome (GBS) is rare and poorly understood and warrants further investigation.

Methods: A detailed case of RCVS in a patient with GBS was presented, followed by a comprehensive literature review. PubMed, Embase, and Google Scholar were searched for relevant cases and studies.

Results: The case involved a 62-year-old woman with GBS who developed RCVS. The literature review identified three additional reported cases. RCVS in GBS primarily affected middle-aged women and presented with a variety of neurological symptoms. Neuroimaging showed reversible vasoconstriction in the cerebral arteries, along with other complications such as posterior reversible encephalopathy syndrome, subarachnoid hemorrhage, and infarcts. While the treatment for GBS consisted mainly of intravenous immunoglobulin, specific treatments for RCVS remain unclear.

Conclusions: The coexistence of RCVS and GBS is a rare occurrence. RCVS in GBS may result from the disruption of cerebral vascular tone regulation, possibly influenced by GBS-related dysautonomia and consequent high blood pressure. Recognizing RCVS in GBS patients is critical for appropriate management.

Keywords: Dysautonomia; Guillain-Barre syndrome; Hypertension; Reversible cerebral vasoconstriction syndrome.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cerebrovascular Disorders* / complications
  • Female
  • Guillain-Barre Syndrome* / complications
  • Humans
  • Middle Aged
  • Posterior Leukoencephalopathy Syndrome* / diagnosis
  • Subarachnoid Hemorrhage* / complications
  • Vasoconstriction / physiology
  • Vasospasm, Intracranial* / complications
  • Vasospasm, Intracranial* / diagnostic imaging