DOI: 10.36347/sjmcr.2021.v09i05.021

Pages: 540-541

Guillian Barre Syndrome (GBS) is a clinical diagnosis with typical electrophysiological features which evolve over 1-2 weeks. H reflex and F wave abnormalities are the earliest to appear. In this report, H reflex abnormality as an isolated feature even after two weeks of illness is an unusual feature which is highlighted by this case report. 38 year old male patient presented with history of antecedent febrile illness presented with progressive weakness of lower limbs of three days duration. He had areflexic proximal more than distal weakness of lower limbs more than upper limbs. Cerebrospinal fluid analysis showed albumin0- cytological dissociation. Nerve conduction study done on day 3 and day 13 showed an absent H reflex despite clinical progression. Patient responded well to immunotherapy. The importance of minor but definitive abnormalities on nerve conduction when collaborated with clinical findings is extremely useful in the clinical diagnosis of GBS.