2025 American Academy of Neurology Abstract Website

Objective:

Background:

Guillain–Barré syndrome (GBS) is an immune-mediated polyneuropathy which usually present as monophasic disease marked by progressive flaccid paralysis or other atypical manifestation. Efgartigimod, a human IgG antibody Fc fragment that acts as a natural ligand for the FcRn, can increase IgG degradation, which may be a promising therapeutic drug for GBS and shorten the recovery time.

Design/Methods:

We present two cases diagnosed with GBS. The first case involved an initial presentation of ataxia, followed by dysphagia and dysarthria on the fifth day and admitted to the hospital on the seventh day, with cerebrospinal fluid analysis revealing protein-cell dissociation and positive serum GD1a, GT1a, and GQ1b antibodies. The second case presented with acute pain, progressing to limb weakness and bedridden by the third day and admitted to the hospital on the fourth day, with cerebrospinal fluid analysis also indicating protein-cell dissociation, but with negative serum ganglioside antibodies.

Both patients commenced treatment with Efgartigimod at a dosage of 15mg/kg, administered every five days for a total of two doses.

Two patients regained the ability to walk on the second and sixth day of treatment. In the second case, the patient developed bilateral facial paralysis on the seventh day, and fully recovered by the seventeenth day. Other atypical manifestation such as ataxia ,dysphagia, dysarthria and acute pain also recovered quickly(within one week).

Results:

Efgartigimod, administered at 15mg/kg twice within five days, can rapidly improve walking ability in GBS patients and also quickly alleviate other atypical symptoms such as dysphagia, dysarthria, acute pain, and facial paralysis.

Conclusions:

Efgartigimod may become a potential new drug for the treatment of GBS, warranting further large-scale clinical studies.