The patient was admitted to ICU and further treatment was carried out in strict compliance with the isolation measures. Our patient received PPh every 2 days, and there was a clinical deterioration in spite of this treatment during the first 5 days. The patient developed a flaccid, severe tetraparesis of 3/5 in the proximal, 1/5 in the distal of the upper extremities and 3/5 in the proximal and 0/5 in the distal of the lower extremities for dorsal extension, 2/5 for flexion, a trunk instability, and also bilateral peripheral facial nerve palsy (House–Brackmann grade 5). There were autonomous symptoms with a tachycardic heart action until 120/min and a severe orthostatic dysregulation, with no further possibility of sitting upright. She showed a tendency for clinical improvement after the third course of PPh. Seven courses of PPh were performed. The PPh caused a slightly further clinical improvement with asymmetrical improvement of facial paresis and tetraparesis, but a clinical stagnation of the improvement during the following 5 days. The patient was still unable to sit upright because of orthostatic collapsing and trunk instability. Therefore, we added 5 days after the last PPh 0.40 g/kg/day intravenous immune globulins for a duration of 5 days.