Pharyngeal cervical brachial entities

Clinic

• PCB is a variant of Guillain–Barré syndrome
• It is defined by
  • Rapidly progressive oropharyngeal (Facial palsy, Dysarthria)
  • Cervicobrachial weakness
  • Areflexia in the upper limbs
• It presents with rapidly progressive oropharyngeal and cervicobrachial weakness, associated upper limb weakness, and hyporeflexia
• PCB is a localized subtype of GBS characterized by axonal rather than demyelinating neuropathy.
• It is often misdiagnosed as brainstem stroke, myasthenia gravis or botulism.
• The presence of additional ophthalmoplegia and ataxia indicates overlap with Fisher syndrome.
• Half of patients with PCB carry IgG anti-GT1a antibodies which often cross-react with GQ1b, whereas most patients with Fisher syndrome carry IgG anti-GQ1b antibodies which always cross-react with GT1a.
• Significant overlap between the clinical and serological profiles of these patients supports the view that PCB and Fisher syndrome form a continuous spectrum.