Abstract:

Objective To investigate the clinical characteristics and treatment strategies of pure sensory Guillain-Barré syndrome (GBS) accompanied by a sensory level. Methods A retrospective analysis was conducted on a case of pure sensory GBS with a sensory level, supplemented by a literature review. Results A 22-year-old male developed numbness, tightness, and hyperalgesia in both lower limbs after a cold. Symptoms progressed to the inguinal level within 3 days and peaked. Sensory disturbances were confined below the inguinal level. Physical examination revealed hyperalgesia and impaired deep sensation in the lower limbs, especially in the distal end. Positive Romberg's sign, absence of tendon reflexes in all limbs, and negative pathological reflexes were found. Lumbar puncture examination of cerebrospinal fluid suggested protein-cell separation, serum anti-GD1a antibody IgG (++), anti-Sulfatides antibody IgG (+), and electrophysiological studies showed no abnormalities. The patient was diagnosed with pure sensory GBS. Symptoms were alleviated after receiving immunoglobulin pulse therapy and neurotrophic treatment. Conclusion The presence of a sensory level and purely sensory manifestations are both atypical features of GBS, and their co-occurrence is rare. Positive cerebrospinal fluid or serum peripheral nerve antibodies are crucial for diagnosis. Current treatment lacks high-level evidence, but intravenous immunoglobulin therapy can alleviate symptoms.

Key words: Guillain-Barré syndrome, pure sensory variant, sensory level, GD1a antibody positive, Sulfatide antibody positive