Guillian Barre syndrome is an acute ascending flaccid paralysis that is often preceeded by a mild bacterial
or viral infection. Anti ganglioside antibodies detected in serum have been proposed to contribute to the
immunopathogenesis of GBS. Management options including supportive care, physiotherapy, intravenous
immunoglobulin and plasmapheresis. IVIG have been shown to effectively remove serum anti GM1 IgG
antibo dies which is considered as one of the major contributing factor for the pathogenesis of GBS. We
document an interesting case of a four year old girl who was diagnosed with GBS, and later on developed a
facial palsy during the IVIG treatment, while weaknes, areflexia and other symptoms were improving. The
IVIG treatment has a beneficial effect on GBS, but some times it may not arrest the development of facial
palsy. The mechanism of such a variable effect of IVIG on GBS is hypothesized and discussed here.
Key words: Guillian Barre syndrome, IVIg, Facial palsy.