• Marek Sykora, Jennifer Diedler, Werner Hacke, and Roland Veltkamp.
• Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. marek.sykora@med.uni-heidelberg.de
• Neurocrit Care. 2008 Jan 1; 9 (3): 374-7.

IntroductionDysautonomia is a characteristic finding in Guillain-Barré syndrome (GBS). Sinus tachycardia, blood pressure instability, sustained hypertension or hypotension, cardiac arrhythmias, sweating abnormalities, gastrointestinal or urogenital symptoms, and neurogenic stunned myocardium have been previously described in patients with GBS. To our knowledge, increased intrapulmonary shunts in association with GBS have not yet been reported.MethodsWe present a case of GBS with severe dysautonomia associated with clinical relevant intrapulmonary shunts. Autonomic functions were tested using baroreflex sensitivity and heart rate variability measures. Intrapulmonary shunts were calculated according to the Berggren formula.ResultsAutonomic functions showed excessive sympathetic activation. Intrapulmonary shunts were increased up to six times compared to the norm. Other causes of increased intrapulmonary shunts, such as sepsis, pulmonal or cardiac complications, were excluded during hospitalization.ConclusionIntrapulmonary shunts in GBS may relate to sympathetic overactivation and should be anticipated in GBS patients with unexplained respiratory deterioration.

23 keywords...

hide…