BACKGROUND: Guillain-Barré Syndrome (GBS) is a rapidly progressive 
immune-mediated polyneuropathy often associated with an antecedent infectious 
illness or vaccination. The classic presentation of GBS is characterized by 
ascending limb weakness and numbness with loss of reflexes. However, atypical 
variants involving the face and arms or with purely sensory symptoms also exist. 
In up to 30% of cases, GBS progresses to respiratory failure, with patients 
requiring mechanical ventilation.
CASE REPORT: We report a case of atypical GBS occurring after Coronavirus 
disease 2019 (COVID-19) vaccination in an otherwise healthy 38-year-old man. The 
patient's clinical presentation was characterized by bilateral hand and foot 
paresthesias, dysarthria, bilateral facial weakness, and an absence of classic 
ascending limb weakness. Albuminocytological dissociation within the 
cerebrospinal fluid was suggestive of GBS. The patient received intravenous 
immunoglobulin therapy, with modest improvement in his symptoms at the time of 
his discharge from the hospital. Why Should an Emergency PhysicianBe Aware of 
This? Patients with GBS are at risk for life-threatening complications, 
including respiratory failure requiring mechanical ventilation. It is critical 
for emergency physicians to be aware of the manifold presentations of GBS for 
early recognition and treatment. This may be of particular importance in the 
context of a worldwide vaccination campaign in response to the COVID-19 
pandemic.