Guillain-Barré Syndrome (GBS) is a rare but serious autoimmune disorder, affecting the peripheral nervous system (PNS). Highlighting the magnitude of the problem, globally, it has an annual incidence of 1–2 cases per 100,000 people [
1]. However, regional differences in the incidence rate has been observed. As per the prevalence surveys done in Europe, Asia, America, and Australia, 0.4 to 4 GBS cases per 100,000 people have been reported annually [
2]. In Asia, an annual incidence of 1.71, 1.82, 0.42 GBS cases per 100,000 people have been observed in China, South Korea, and Japan respectively [
3,
4]. These cases have been more frequently reported during the monsoon season in some regions [
2,
5]. However, contradicting this, in other geographical locations, studies have reported the peak of GBS cases in summer and winter, thus pointing towards a regional variation in the seasonality of the cases. Some studies also suggest that there is no discernible seasonal fluctuation [
6,
7]. Increased incidence in GBS is also observed during outbreaks and pandemics. A recent instance is the significant rise in GBS cases following the COVID-19 pandemic [
8‐
10]. Although the exact cause of GBS is still unknown, it is speculated to be a post-infectious condition since 2/3rd of the patients suffer from some form of infectious disease before the neurological condition sets in [
11,
12]. Many bacterial and viral infections have been implicated in triggering the immune system against nerves, damaging it. As a consequence, weakness and tingling sensation in the extremities progressing to acute flaccid paralysis is seen [
12,
13]. Less than one-third of the patients with GBS require mechanical ventilation due to respiratory muscle weakness. A mortality rate of 1–18% has been reported in such patients [
14,
15]. Early diagnosis and treatment with intravenous immunoglobulin or plasmapheresis are effective in reducing the severity of the illness and aid in the recovery of the patients [
12]. GBS is mostly a monophasic condition, but recurrence is observed in about 3–10% of the patients. It may occur at any age, however, higher incidences have been observed in adults compared to children with a predominance seen in males [
16,
17].
GBS is a heterogeneous disorder having regional variation with respect to the clinical presentation, electrophysiological subtype, and outcome [
18]. The lack of definitive cause and effective treatment is a major challenge that clinicians are facing even after 100 years since the reporting of the first case of GBS. Herein, we present a clinical case of fulminant GBS with antecedent Chikungunya infection. Chikungunya infection is an acute febrile illness usually associated with rashes and arthralgia, transmitted through
Aedes aegypti and
Aedes albopictus mosquitoes [
19,
20]. Although meningitis, encephalitis, and GBS have been documented as consequences of a severe acute Chikungunya infection, neurological complications are uncommon [
21]. Neurological complications of Chikungunya infection, including one case of GBS were first observed during the outbreak of 1964 in Madras, India [
22].
The objectives of this review include: (i) reviewing the antecedent infections in GBS, (ii) illustrating the pathogenesis of GBS, (iii) describing the clinical features, and (iv) summarizing the treatment and management.