Bulbar disorders in the onset of Guillain-Barre syndrome (GBS) are rare and create diagnostic difficulties. A 50-55-year-old patient was hospitalized due to the development of dysarthria, ataxia, nasolalia, paresthesia and increased drowsiness, which reached the greatest severity after a day. An atypical variant of GBS was diagnosed. According to its manifestations, it corresponded to "acute bulbar paralysis plus". The peculiarity was the absence of an increase in protein in CSF by the end of the 2nd week of the disease and the absence of antibodies to gangliosides in the blood. Treatment included plasmapheresis. After a month, all clinical symptoms regressed. GBS in atypical cases can manifest with bulbar disorders and ataxia, which must be taken into account in the differential diagnosis with a stem stroke.

Guillain-Barre syndrome, acute bulbar palsy–plus; Bickerstaff stem encephalitis.

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