Epstein–Barr virus infection antedating bilateral hypoglossal nerve palsy with the IgG anti-GalNAc-GD1a antibody

Excerpt

Spectrum of Guillain–Barré syndrome (GBS) is expanded due to variants or subtypes accounting for atypical forms without progression [1‐3]. Multiple lower cranial nerves (CN) dysfunction presenting with acute pharyngeal and palatal weakness, even in the absence of limb involvement, ataxia or areflexia are considered regional GBS, which Ropper [1] described as abortive forms of the disease. In clinical practice, isolated hypoglossal nerve palsy poses a challenging dilemma, because the nerve long course predisposes to wide spectrum of etiologies, including compression, neoplastic, inflammatory disorders [4]. We report a patient presenting with exclusive, bilateral hypoglossal palsy after Epstein–Barr infection (EBV) with serum immunoglobulins G (IgG) antibodies to the N-acetylgalactosaminyl GD1a (GalNAc-GD1a) ganglioside. …