Severe Guillain-Barré syndrome after mRNA COVID-19 vaccination with rapid deterioration and recovery: a case report.

Guillain-Barré syndrome (GBS) is an acute immune-mediated polyneuropathy characterised by rapidly progressive weakness, sensory disturbance, and autonomic dysfunction, often requiring intensive supportive care. While most cases follow gastrointestinal or respiratory infections, rare cases have been reported after vaccination. A 72-year-old man developed progressive symmetrical weakness and areflexia three weeks after receiving an mRNA COVID-19 vaccine. His condition deteriorated to bulbar dysfunction and respiratory failure, requiring intubation, tracheostomy, and prolonged ventilatory support. Cerebrospinal fluid analysis demonstrated albuminocytologic dissociation, while neuroimaging excluded structural pathology. Intravenous immunoglobulin was initiated promptly, followed by intensive multidisciplinary rehabilitation, including hydrotherapy. He gradually improved, was successfully decannulated, and transferred to a rehabilitation facility. This case highlights a rare possible post-vaccination association while emphasising that causality remains uncertain. Early recognition, close respiratory monitoring, and comprehensive rehabilitation are essential, as meaningful recovery is achievable even after severe disease.