Abstract: Objective To investigate the clinical features of patients with multi-cranial nerves impairments as the onset of Guillain-Barré syndrome (GBS). Methods 10 patients of GBS with complaint of multiple cranial neuropathy were analyzed retrospectively. Results The cranial nerves Ⅶ, Ⅸ and Ⅹ were involved at the onset of GBS, tending to affect men rather than women (4∶1), aged of 18～55 years old (8/10), and with less the antecedent of infection. The knee and ankle jerk reflexes were minimal or absent in all the patients, and the meningeal irritation signs were observed in 4 patients. Assisted ventilation was required in 4 patients during the course of their illness. The cerebrospinal fluid (CSF) characterized with increased protein concentration but a normal cell count in 2 patients in the first week, and all the patients in the following 3 weeks. The incidence of motor conduction velocity (MCV) and F waves abnormalities of electrophysiological evaluation were 81.25% and 94.44% respectively. The Hughes scales were (4.00±0.82) before treatment, and were (2.25±0.96, P=0.012) and (0.50±1.00, P=0.000) 14 d and 28 d after intravenous immunoglobulin (IVIG). Conclusion The probability of GBS should be considered in patients with multiple cranial neuropathy, especially the cranial nerves VII, IX and X impairments without precise causes. The early electrophysiological studies and CSF examinations may be useful for diagnosis. IVIG can be preferred as an effective treatment.

Key words: Guillain-Barré syndrome (GBS), cranial nerve, diagnosis, treatment