Unveiling the Devastating Impact of Atypical and Rapidly Evolving Guillain-Barre Syndrome: A Report of Two Cases.

Guillain-Barré syndrome (GBS) is an immune-mediated demyelinating disease; weakness is typically ascending in nature with areflexia. Any deviation from this typical course becomes a diagnostic challenge with variable prognosis. Here, we report cases of GBS presenting with rapidly evolving descending weakness with predominant bulbar involvement and dysautonomia as an atypical presentation, which can lead to delay in diagnosis and treatment. We also highlight how atypical GBS are slow responders to immunomodulation therapy like intravenous immunoglobulin (IVIG) and plasma exchange, and hence, a multidisciplinary approach would modify the outcome.