Nerve ultrasound follow-up in a child with Guillain-Barré syndrome

Objective. The aim of this report is to highlight the importance of close observation and follow-up in children who present with an acutely irritable hip. This is because hip pain is a symptom of not only benign but also severe conditions. Thus, at the time of the initial presentation, hip pain can be misdiagnosed. This report serves as an example for a wide range of doctors such as orthopaedic surgeons, paediatricians, emergency room physicians or primary care physicians, because these are the first-line doctors who treat patients with a painful hip. Case report. We herein present a three-year-old child who was admitted to our hospital with pain in the right leg and initially diagnosed with transient synovitis of the hip. An additional examination two days later, after severe deterioration of the clinical picture, revealed that our patient was actually suffering from Guillain-Barré syndrome. Failure to diagnose Guillain-Barré syndrome and initiating prompt treatment is potentially life-threatening. Conclusion. Clinicians should be aware that hip pain could be the presenting complaint of Guillain-Barré syndrome, a syndrome that has many clinical features. Even when all the clinical and laboratory findings indicate a benign condition, Guillain-Barré syndrome should still be considered. Therefore, close observation and follow-up in children who present with an acutely irritable hip is highly recommended. In this way, the potentially catastrophic consequences of more severe conditions can be avoided.

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The Clinical Features of Asymmetry Weakness in Childhood Guillain-Barre syndrome: The Outcome and 5-year Follow-up

10.21203/rs.3.rs-31710/v1 ◽

2020 ◽

Author(s):

Rui-Di Sun ◽

jun Jiang

Keyword(s):

Guillain Barre Syndrome ◽

Clinical Parameters ◽

Good Recovery ◽

Term Outcome ◽

Long Term Outcome ◽

Guillain Barré Syndrome ◽

Recovery Group ◽

Guillain Barré

Abstract Objectives To compare the clinical profile and long-term outcome of children with asymmetry weakness and symmetry weakness in Guillain-Barre syndrome(GBS). Methods We retrospective analysis the clinical parameters, auxiliary examinations and long-term outcome between asymmetry weakness and symmetry weakness in childhood GBS. Results A total of 72 children were included, 12 children had asymmetry weakness. Six children were transient asymmetry weakness and six children were persistent asymmetry weakness. Compared to symmetry weakness children, asymmetry weakness had more preschool children (75% vs 25%, P=0.005), longer days on hospital(26.5(15-37) days vs 11(9-15) days, p =0.000), more mechanical ventilation in children(50% vs 8.33%, p=0.000), higher Disease severity score(DSS)at nadir of disease(4(3-5) vs 3(1-4), p=0.010), more axonal subtypes(50% vs 15%, p=0.013) and more complications(58.33% vs 8.33%, p=0.000). Eight children had sequelae and sixty-four children had good recovery. Compared to good recovery group, sequelae group had more axonal subtypes(62.5% vs 15.63%, p=0.002) and more persistent asymmetry weakness(62.5% vs 4.69%, p=0.000). Conclusions In conclusion, asymmetry weakness had two types in GBS, namely transient and persistent asymmetry weakness. Asymmetry weakness in GBS indicated more complex condition during disease than symmetry weakness. Persistent asymmetry weakness and axonal subtypes in GBS related with sequelae. Anterior horn cells in the spinal cord involvement may be the possible function in persistent asymmetry weakness combined with axonal subtypes in GBS.

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1680. Guillain Barré Syndrome in Arbovirus Outbreak in Veracruz, Mexico: The Follow-up to 3 Years of the Pandemic

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1544 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S615-S615

Author(s):

Luis Del Carpio-Orantes ◽

Jesús Salvador Sánchez-Díaz ◽

Karla Gabriela Peniche Moguel ◽

Sergio García-Méndez ◽

Miguel Arnulfo Perfecto-Arroyo ◽

...

Keyword(s):

Hepatitis B ◽

Operational Definition ◽

Guillain Barre Syndrome ◽

Suspected Case ◽

Acute Viral Infection ◽

Guillain Barré Syndrome ◽

Definition Of ◽

Guillain Barré ◽

Protocol Study

Abstract Background From the arrival of Zika to America in 2015, and the increase in cases of Guillain sweeten in South America apparently associated with acute viral infection, Mexico had its first contact in 2016, with an increase in the incidence of cases of the syndrome, initiating a protocol study to look for the causal association of the Zika virus syndrome Methods We conducted a descriptive, prospective, and longitudinal study in Veracruz, Mexico, where follow-up of cases of Guillain Barre Syndrome (GBS) occurred during 2016 to 2018. The central point of the study is to look for the etiological association of GBS with the presence of acute zika infection. Secondarily, other know neutropic agents, both viral and bacterial were searched. The diagnosis techniques used were PCR-RT (blood and urine) and IgM/IgG for Zika; serum PCR-RT and IgM/IgG for Dengue and Chikungunya; IgM/IgG for TORCH; PCR-RT in CSF for Herpes and Enterovirus; serological panel of Hepatitis B and C; PCR-RT in rectal swab for Campylobacter. Results A cohort of 39 patients has been formed over 3 years of study. 38 patients met the operational definition of a suspected case of Zika, of which only 2 cases were identified by PCR-RT in urine; During the search protocol for infectious agents, others were identified such as: Dengue, Chikungunya, Enterovirus, Herpes and Hepatitis B; however, the identification of Campylobacter was even more remarkable, also highlighting that only four patients had diarrhea. Regarding the treatment, 37 patients received IVIG, 1 patient received plasmapheresis and 1 patient received both. The prognosis was good in 34 patients (basal Hugues from 4–5 to 2), 5 had poor functional prognosis and died. Conclusion The incidence of Zika as a cause of GBS is relatively low (5%), so the etiological association could not be demonstrated; other neurotropic viral agents were identified, however the presence of Campylobacter cases was more notable (asymptomatic campylobacteriosis). Disclosures All authors: No reported disclosures.

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Peripheral Nerve Ultrasound for Diagnosis and Prognosis of Guillain-Barre Syndrome

Case Medical Research ◽

10.31525/ct1-nct04053452 ◽

2019 ◽

Author(s):

Keyword(s):

Peripheral Nerve ◽

Guillain Barre Syndrome ◽

Nerve Ultrasound ◽

Diagnosis And Prognosis ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Severe Guillain-Barré syndrome after surgery for multiple fractures: a rare case report with a 5-year follow-up and a brief review of the literature

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03864-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jian Chen ◽

Jian-xiong Ma ◽

Cai-hong Zuo ◽

Qing Zhang ◽

Heng-ting Chen ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Orthopaedic Surgery ◽

Motor Nerve ◽

Rare Complication ◽

Lower Limbs ◽

Guillain Barre Syndrome ◽

Multiple Fractures ◽

Guillain Barré Syndrome ◽

Guillain Barré

Abstract Background Guillain-Barré syndrome (GBS) is the most common and serious acute paralytic neuropathy and is usually caused by infection. It is thought to be the result of an aberrant response of the immune system. To our knowledge, GBS, especially severe GBS, after orthopaedic surgery has rarely been reported. Case presentation We herein report the case of a 58-year-old man who developed quadriplegia and respiratory failure on the 6th day after surgery for multiple fractures. The patient had no symptoms of respiratory or gastrointestinal tract infection within 4 weeks before the onset. The white blood cell count was normal, and there was no redness, swelling, heat or pain in the surgical incision. Brain, cervical and thoracic magnetic resonance imaging were normal, albuminocytological dissociation was found on cerebrospinal fluid examination, and electrophysiological examination showed that sensory and motor nerve evoked potentials could not be elicited. A diagnosis of post-traumatic GBS was made, and the patient was treated with intravenous immunoglobulin and plasma exchange, as well as supportive care and rehabilitation exercise. The length of stay was 18 months, and the in-hospital-related costs amounted to $127,171. At the last follow-up, the patient had recovered only grade 3 power in the upper limbs and grade 2 power in the lower limbs. Conclusions Severe GBS is a rare complication after orthopaedic surgery. When progressive weakness occurs in trauma patients, the possibility of GBS should be considered, and cerebrospinal fluid and electrophysiological examinations should be performed in a timely manner. For patients with severe GBS after trauma, the treatment costs may be high, and the prognosis may be poor.

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