‘Not So Atypical’: An Atypical Presentation of West Nile Virus and Guillain-Barre Syndrome

Guillain-Barre Syndrome (GBS) is defined by acute areflexic paralysis, usually starting in the distal lower extremities, and ascending to the upper extremities. It is associated with albuminocytologic dissociation, which involves elevated protein levels and normal cell counts in the cerebrospinal fluid. One of the types of GBS, called Miller-Fischer Syndrome (MFS), is characterized by ophthalmoplegia, ataxia, and areflexia. This case report focuses on a 49-year-old male with an atypical presentation of Guillain-Barre syndrome. Guillain-Barre syndrome can be classically caused by Campylobacter jejuni. However, there can be other infectious causes as well, namely Cytomegalovirus, Epstein-Barr virus, Varicella-Zoster virus, Mycoplasma pneumonia. The aim of this case report is to highlight another infectious cause for Guillain-Barre syndrome – West Nile Virus. Little data is available with respect to West Nile Virus being the cause of GBS. However, our case suggests that West Nile Virus should be in the differential diagnoses for patients presenting with GBS symptoms.