CSF Findings in Guillain-Barré Syndrome: Demyelinating and Axonal Acute Inflammatory Polyneuropathies

Guillain-Barré syndrome (GBS) is an immune-mediated demyelinating disorder which attacks the peripheral nervous system. Antecedent infection or vaccine administration are known to precipitate the onset of this disorder. Its typical presentation leads to a symmetric, rapidly progressive, ascending paresis with associated sensory deficits and impaired reflexes. We present a rare case of a bi-facial diplegia variant of GBS, within four weeks of the COVID-19 vaccination. Due to its chronology, clinical manifestations, and cerebrospinal fluid (CSF) findings, we propose this case to be a rare complication of the COVID-19 vaccination.

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Epidemiological and cohort study finds no association between COVID-19 and Guillain-Barre syndrome

10.1101/2020.07.24.20161471 ◽

2020 ◽

Author(s):

Stephen Keddie ◽

Julia Pakpoor ◽

Christina Mousele ◽

Menelaos Pipis ◽

Pedro M Machado ◽

...

Keyword(s):

Cohort Study ◽

Campylobacter Jejuni ◽

Pulmonary Involvement ◽

Respiratory Viruses ◽

Guillain Barre Syndrome ◽

Negative Thought ◽

Guillain Barré Syndrome ◽

Guillain Barré ◽

The Uk ◽

Csf Findings

Background Reports of Guillain-Barre Syndrome (GBS) have emerged during the Coronavirus Disease 2019 (COVID-19) pandemic. This epidemiological and cohort study sought to investigate any causative association between COVID-19 infection and GBS. Methods The epidemiology of GBS cases reported via the UK National Immunoglobulin Database were studied from 2016-2019 and compared to cases reported during the COVID-19 pandemic. For the cohort study, members of the British Peripheral Nerve Society reported all cases of GBS during the pandemic. The clinical features, investigation findings and outcomes of COVID-19 (definite or probable) and non-COVID-19 associated GBS cases were compared. Results The UK GBS incidence from 2016-2019 was 1.65-1.88 per 100,000 people per year. GBS and COVID-19 incidence varied between regions and did not correlate (r = 0.06, 95% CI -0.56 to 0.63, p=0.86). GBS incidence fell between March and May 2020 compared to the same months of 2016-2019. Forty-seven GBS cases were included in the cohort study (13 definite, 12 probable COVID-19 and 22 non-COVID-19). There were no significant differences in the pattern of weakness, time to nadir, neurophysiology, CSF findings or outcome. Intubation was more frequent in the COVID-19+ve cohort (7/13, 54% vs 5/22, 23% in COVID negative) thought to be related directly to COVID-19 pulmonary involvement. Conclusions This study finds no epidemiological or phenotypic clues of SARS-CoV-2 being causative of GBS. GBS incidence has fallen during the pandemic which may be the influence of lockdown measures reducing transmission of GBS inducing pathogens such as Campylobacter jejuni and respiratory viruses.

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A Rare case of recurrent Guillain-Barré syndrome without albuminocytological dissociation

BMJ Case Reports ◽

10.1136/bcr-2018-226572 ◽

2018 ◽

pp. bcr-2018-226572

Author(s):

Anudeep Yelam ◽

Elanagan Nagarajan ◽

Raghav Govindarajan ◽

Pradeep C Bollu

Keyword(s):

Cerebrospinal Fluid ◽

Rare Case ◽

Guillain Barre Syndrome ◽

Csf Analysis ◽

Immune Mediated ◽

Guillain Barré Syndrome ◽

Sensory Disturbances ◽

Guillain Barré ◽

Csf Findings

Guillain-Barré syndrome (GBS) is an immune-mediated polyneuropathy, often preceded by an illness. It is a self-limiting illness in most of the cases, but recurrence is rare and can be seen in about 1%–6% of patients. GBS is characterised by progressive, symmetrical, proximal and distal weakness. Areflexia and sensory disturbances are also common. Patients with GBS usually have albuminocytological dissociation on cerebrospinal fluid (CSF) analysis. This is a case of a 69-year-old woman with recurrent GBS and normal CSF findings.

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