Background: Guillain-Barré syndrome has been regarded as a spectrum of diseases with many variants. Objective: To present a case in which, when the ocular muscles are affected in the beginning, it is very challenging to distinguish Guillain-Barré syndrome from myasthenia gravis. Case Report: We describe a patient with Guillain-Barré syndrome who presented initially with isolated ptosis without ophthalmoplegia and subsequently developed descending paralysis. Due to the primary involvement of the lid levators, the patient was initially diagnosed as having a myasthenic crisis. Conclusion: Although extremely rare, Guillain-Barré syndrome can present initially as isolated ptosis with subsequent descending paralysis.
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