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KMID : 1201420210140010052
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Journal of Neurocritical Care
2021 Volume.14 No. 1 p.52 ~ p.56
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Paralytic rabies mimicking Guillain-Barre syndrome: the dilemma still prevails
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Surve Rohini M.
Pendharkar Hima S.
Bansal Sonia
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Abstract
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Background: Paralytic rabies lacks the hallmark signs of rabies at presentation and is often misdiagnosed as Guillain-Barre Syndrome (GBS). Sensitive antemortem diagnostic criteria for rabies is lacking, and the diagnosis is confirmed posthumously by demonstrating Negri bodies on brain biopsy. Antemortem brain and spine magnetic resonance imaging findings have recently been reported for paralytic rabies.
Case Report: We report a case of paralytic rabies in a young boy who was initially misdiagnosed with GBS. In this case, brain and spine magnetic resonance imaging (MRI) findings pointed towards paralytic rabies, which was confirmed by the presence of anti-rabies antibodies in the serum and cerebrospinal fluid analysis, and posthumously by Negri bodies on brain biopsy.
Conclusion: In patients with GBS, paralytic rabies should be considered as an alternative diagnosis, especially in regions where rabies is endemic, and early MRI of the brain and spine should be considered for the antemortem diagnosis of paralytic rabies.
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KEYWORD
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Paralytic rabies, Guillain-Barre syndrome, Magnetic resonance imaging
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