A 70-year-old woman hospitalized for muscular weakness in the extremities was found in electrocardiography on admission to have ST-segment elevation in leads II, III, aVF and V₁ through V₄, and inverted Twaves were seen in II, III, aV_F and V₂ to V₆. Although no stenotic lesion was detected in emergency coronary angiography, left ventriculography showed a hypokinetic area around the apex with an ejection fraction of 31%. ¹²³I-MIBG myocardial scintigraphy showed an extensive defect around the apex. These findings supported a diagnosis of “Takotsubo” -like cardiomyopathy.
Forty days after admission, albuminocytogenic dissociation of cerebrospinal fluid led us to diagnose Guillain-Barré syndrome as responsible for the weakness in the extremities.
Guillain-Barré syndrome may damage the sympathetic nervous system, so we concluded that abnormality of the cardiac sympathetic nervous system due to Guillain-Barré syndrome and diabetic autonomic neuropathy caused cardiac dysfunction. Diabetes complicated “Takotsubo” -like cardiomyopathy followed by Guillain-Barré syndrome is extremely rare.