Autonomic Dysfunction Progression in a Guillain-Barré Syndrome Patient with Suspected Sepsis: A Case Report

Abstract

Guillain-Barré Syndrome (GBS) is an autoimmune disease affecting the peripheral nervous system, potentially leading to progressive muscle weakness, respiratory failure, and autonomic dysfunction. Severe autonomic dysfunction may result in arrhythmias, blood pressure fluctuations, and vital organ dysfunction, often worsened by sepsis. This report adopted a case report approach of a patient with GBS and severe autonomic dysfunction accompanied by suspected sepsis. Data were thoroughly collected through direct observation, comprehensive review of medical records, and detailed analysis of laboratory, electrocardiogram (ECG), and radiological findings. Analysis was conducted using both clinical and theoretical frameworks. This case report aims to describe autonomic symptom changes in GBS with suspected sepsis and to analyze their clinical implications for nursing care in critically ill patients A 51-year-old male patient presented with progressive extremity weakness, respiratory failure, and required mechanical ventilation. During intensive care, the patient developed second-degree AV block, sinus tachycardia, hypotension, persistent fever, and leukocytosis. These manifestations indicate severe autonomic dysfunction affecting both sympathetic and parasympathetic control on patient. Interventions included mechanical ventilation, intravenous immunoglobulin (IVIg), vasopressors, broad-spectrum antibiotics, and haemodynamic monitoring. The patient’s autonomic symptom changes reflected dysfunction of both sympathetic and parasympathetic nervous systems, as indicated by cardiac rhythm disturbances and blood pressure instability during intensive care. AV block indicated sinoatrial node involvement, while sinus tachycardia suggested sympathetic dominance during sepsis. Haemodynamic instability, observed through fluctuating heart rate and hypotension requiring vasopressor support, illustrated the complex interaction between GBS and sepsis. This case highlights that severe autonomic dysfunction in GBS may lead to AV block and sinus tachycardia, aggravated by sepsis. This case suggests that nurses caring for patients with GBS should maintain a high level of vigilance for autonomic instability including arrhythmias and blood pressure changes, especially in the presence of sepsis. Intensive management and continuous monitoring are critical to stabilize autonomic function and improve clinical outcomes in critically ill patients.