Guillan-Barre syndrome triggered by heat stroke: clinical case and literature review


  • Juan Carlos López-Hernández Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez
  • Lilia Salas Alvarado Intituto Nacional de Neurología y Neurocirugía
  • Victoria Martínez Angeles Intituto Nacional de Neurología y Neurocirugía
  • Elma Paredes Aragon Intituto Nacional de Neurología y Neurocirugía
  • Edwin Steven Vargas Cañas Instituto Nacional de Neurología y Neurocirugía


Guillain-Barré syndrome, heat stroke, Case Report


Introduction: Guillain-Barre syndrome is triggered in 70% of cases by some infectious agent. Heat stroke favors a pro-inflammatory state and endotoxemia at the gastrointestinal level. Few clinical cases of GBS following heat stroke are reported.

Objective: to report a clinical case of a patient who presented GBS after heat stroke.

Material and methods: clinical case report

Result: a 31-year-old male patient in agricultural occupation, presented heat stroke due to exertion while working (temperature 40ºC, epileptic seizures and drowsiness), requiring invasive mechanical ventilation, control of hyperthermia with physical means; presents good evolution, recovering and being discharged at home. On the day of his discharge, he presented symptoms of distal paresthesia and weakness in the 4 extremities ascending until he could not ambulate. In the examination without involvement of skull nerves, areflexia, strength in extremities with MRC score 28 points. Lumbar puncture with protein-cytological dissociation, nerve conduction compatible with AMSAN variant. He was diagnosed with GBS (level 1 of diagnostic certainty by Brighton criteria) after heat stroke, received management with human immunoglobulin, at 3 months of follow-up he recovered his independent gait.

Conclusion: Heat stroke is a potentially fatal condition, triggering a systemic pro-inflammatory state and endotoxemia at the gastrointestinal level, conditions that can facilitate the presentation of autoimmune inflammatory diseases such as Guillaín-Barre syndrome. More studies are required to establish the pathophysiology of GBS after heat stroke.


- Shahrizaila N, Lehmann HC, Kuwabara S. Guillain-Barré syndrome. Lancet. 2021 Mar 27;397(10280):1214-1228. doi: 10.1016/S0140-6736(21)00517-1. Epub 2021 Feb 26. PMID: 33647239.

- López-Hernández JC, Galnares-Olalde JA, Gutiérrez A, Estrada SA, García-Grimshaw M, Vargas-Cañas ES. Guillain-Barre syndrome in Mexico: clinical features and validation of Brighton Collaboration Group criteria. Rev Neurol. 2022 Apr 16;74(8):258-264. English, Spanish. doi: 10.33588/rn.7408.2021437.

- Galnares-Olalde JA, López-Hernández JC, García-Grimshaw M, Valdés-Ferrer SI, Briseño-Godínez ME, de-Sarachaga AJ, Alegría-Loyola MA, Bazán-Rodriguez A, Martínez-Jiménez E, Vargas-Cañas ES. Guillain-Barré Syndrome in Mexico: An Updated Review Amid the Coronavirus Disease 2019 ERA. Rev Invest Clin. 2022 May 1;74(3):121-130. doi: 10.24875/RIC.22000006.

- Ni XX, Wang CL, Guo YQ, Liu ZF. Analysis of Clinical Symptoms of Guillain-Barré Syndrome Induced by Heat Stroke: Three Case Reports and Literature Review. Front Neurol. 2022 Jun 17;13:910596. doi: 10.3389/fneur.2022.910596.

- Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002 Jun 20;346(25):1978-88. doi: 10.1056/NEJMra011089. PMID: 12075060.

-Uzawa A, Mori M, Tamura N, Takahashi H, Hirasawa H, Hattori T, Kuwabara S. Bickerstaff brainstem encephalitis after heat stroke. J Neurol. 2006 Apr;253(4):533-4. doi: 10.1007/s00415-005-0021-y.

-Pfeiffer G, Steffen W. Guillain-Barré syndrome after heat stroke. J Neurol Neurosurg Psychiatry. 1999 Mar;66(3):408. doi: 10.1136/jnnp.66.3.408.

- Bouchama A, Abuyassin B, Lehe C, Laitano O, Jay O, O'Connor FG, Leon LR. Classic and exertional heatstroke. Nat Rev Dis Primers. 2022 3;8(1):8. doi: 10.1038/s41572-021-00334-6.

- Sucholeiki R. Heatstroke. Semin Neurol. 2005 Sep;25(3):307-14. doi: 10.1055/s-2005-917667. PMID: 16170743.

-Leon LR, Helwig BG. Heat stroke: role of the systemic inflammatory response. J Appl Physiol (1985). 2010 Dec;109(6):1980-8. doi: 10.1152/japplphysiol.00301.2010.



How to Cite

López-Hernández, J. C. ., Salas Alvarado, L., Martínez Angeles, V., Paredes Aragon, E., & Vargas Cañas, E. S. (2023). Guillan-Barre syndrome triggered by heat stroke: clinical case and literature review. Archivos De Neurociencias, 1(Inpress). Retrieved from



Case report

Most read articles by the same author(s)