A rare case of Guillain barre syndrome with overlapping cerebral sinus venous thrombosis masquerading as acute psychosis following COVID-19 vaccination

Abstract

Guillain barre syndrome (GBS) is a rare autoimmune condition that has a prevalence of 1-2 per 100,000 people each year. Cerebral sinus venous thrombosis (CSVT) occurs at a rate of three to four cases per one million individuals annually. Both have variable clinical presentation with significant morbidity. The therapeutic management of CSVT and GBS presents unique challenges due to peculiar relationship and overlap in presentation. Reports suggest that psychosis may result from autoimmune encephalitis after receiving the COVID-19 vaccination. Hereby the reported case is of a female who is 18 years of age presenting with acute psychotic and catatonic symptoms following covid 19 vaccination with weakening of limbs which suspected an underlying organic pathology. Magnetic resonance imaging was normal but magnetic resonance venogram showed transverse and sigmoid sinus thrombosis and later GBS with CSVT after Covid-19 vaccination was diagnosed. The case was chosen to report a rare condition with an atypical presentation.