Is Testosterone a Potential Agent for Patients with Delayed Recovery from Guillain-Barre Syndrome?

Background: Management of some of the patients with Guillain-Barre syndrome is challenging, requiring weeks to months of intensive care and prolonged institutional care. Case report: We report a 32-year-old male with acute inflammatory demyelinating polyneuropathy (AIDP) with markedly delayed recovery. He was ventilator dependent and multiple therapeutic interventions were attempted. Other possible contributing factors for delayed recovery were looked into. Co-existing critical illness myopathy and polyneuropathy with low level of serum testosterone were detected. Following replacement of testosterone, he was weaned off from the ventilator within a short period of time after eleven weeks of ventilator dependency and slow recovery of neurological weakness had been achieved resulting in total independency and normal working capacity. Conclusion: Delayed recovery in GBS could be multifactorial. The effects of neuroendocrine changes in a critical illness could alter the expected recovery process. Thus, the role of testosterone in recovery from peripheral nerve injury, as well as in critical illness myopathy needs to be looked into.