P106 Acute “axonal” Guillain-Barre syndrome. Demonstration of early peripheral nerve conduction-blocks in a patient

Guillain Barré syndrome (GBS) varies both in terms of clinical phenotype and underlying pathology. Serial assessments allow greater understanding of the pathophysiology. The evolution of neurophysiological changes is particularly helpful in distinguishing between demyelination and reversible axonal conduction failure.Bilateral facial weakness with distal paraesthesias is a rare subtype of GBS. In the largest case series 64% had abnormalities in motor and 27% in sensory conduction on single neurophysiological assessments; this was interpreted as a demyelinating neuropathy.We report an 18-year-old male with bilateral lower motor neurone facial weakness preceded by distal paraesthesias following a ‘flu-like illness. Examination of power and sensation was normal. Deep tendon reflexes were present. Cerebrospinal fluid showed albuminocytologic dissociation. By 6 weeks his facial weakness had almost completely resolved without treatment.Serial nerve conduction studies were performed. The first study (day 4) found prolonged distal motor latency and delayed F waves in posterior tibial and common peroneal nerves; normal sensory studies. Second study (day 18) found distal motor latencies and F waves had increased in upper and lower limb nerves. Third study (day 60) found improvement but abnormalities remained with changes similar to the first study.The neurophysiological changes became more marked while he improved clinically. These serial studies confirmed the primary pathological process of this GBS variant to be demyelination.

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LANDRY‐GUILLAIN‐BARRE SYNDROME IN INFECTIOUS MONONUCLEOSIS: UNUSUAL NERVE CONDUCTION FINDINGS

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1971.tb92684.x ◽

1971 ◽

Vol 2 (20) ◽

pp. 1024-1027

Author(s):

Paul C. Bartley

Keyword(s):

Infectious Mononucleosis ◽

Nerve Conduction ◽

Guillain Barre Syndrome ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Phrenic nerve conduction time in Guillain-Barre syndrome.

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp.48.3.245 ◽

1985 ◽

Vol 48 (3) ◽

pp. 245-249 ◽

Cited By ~ 30

Author(s):

M Gourie-Devi ◽

G R Ganapathy

Keyword(s):

Phrenic Nerve ◽

Nerve Conduction ◽

Guillain Barre Syndrome ◽

Conduction Time ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Study of Guillain-Barre syndrome etiology in Pakistani patients

Journal of the Pakistan Medical Association ◽

10.47391/jpma.202 ◽

2021 ◽

Author(s):

Rashid Iqbal ◽

Muhammad Javaid Asad ◽

Saima Siddiqi ◽

Raja Tahir Mahmood ◽

Muhamamd Baseer Shah ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Nerve Conduction ◽

Treatment Strategies ◽

Guillain Barre Syndrome ◽

Clinical Feature ◽

Interleukin 17 ◽

Healthy Controls ◽

Female Ratio ◽

Guillain Barré Syndrome ◽

Guillain Barré

Objective: To examine clinical features, biochemical markers, demographic features, antecedent infections, frequency and treatment strategies. Methods: This case-control study was conducted at Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan and District Headquarters Hospital (DHQ), Rawalpindi, Pakistan from 2018 to 2020. Ninety consecutive patients of Guillain-Barré syndrome (GBS) and 77 healthy controls were enrolled. Patients were diagnosed by clinical presentation, Nerve conduction study (NCS), Electromyography (EMG), Cerebrospinal fluid analysis (CSF) and biochemical profile. Data was analyzed on IBM SPSS version 23. Results: Symmetrical ascending weakness was the striking clinical feature. Mean age was 40.20±14.90 years and male to female ratio was 2.1:1. Acute inflammatory demyelinating polyneuropathy (AIDP) was found to be the most common electrophysiological variant of GBS (46%). There was considerable difference in Interleukin-17(IL-17) levels between GBS patients 23.12 ± 3.41 pg/ml and healthy controls 8.82 ± 2.49. Mean IL-17 level was markedly increased in GBS patients, P=0.006, P<0.05. Gastrointestinal infection was the most common preceding infection (56.66%). Mean CSF protein was 100.83 g/dl with ± 51.32 standard deviation and albumio cytologic dissociation (ACD) was different in all four variants of GBS, P= 0.005. Conclusion: GBS was presented by all ages. Males were more affected than females. About two third of GBS patients showed an antecedent infection before GBS onset. Increased levels of cytokine (IL-17) showed involvement of autoimmunity. ACD differentiated it from poliomyelitis. Plasmapheresis and intravenous immunoglobulin (IVIG) therapy were used to treat patients. Key words: Guillain-Barré Syndrome; cerebrospinal fluid; albuminocytologic dissociation; nerve conduction studies; variants; electromyography Continuous....

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A Case Report on Post COVID -19 Vaccine Associated Guillain–Barré Syndrome

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i59b34403 ◽

2021 ◽

pp. 454-458

Author(s):

S. Hemalatha ◽

M. Karishma ◽

J. Bera ◽

S. Blessy ◽

J. Thirumaran ◽

...

Keyword(s):

Case Report ◽

Nerve Conduction ◽

Muscle Power ◽

Ventilatory Support ◽

Infectious Agent ◽

Guillain Barre Syndrome ◽

Autonomic Nerves ◽

Intravenous Immunoglobulin Therapy ◽

Guillain Barré Syndrome ◽

Guillain Barré

Guillain–Barré syndrome (GBS) is an autoimmune demyelinating illness in which a patient’s immune system attacks and cause deterioration of peripheral nervous system leading to progressive paralysis and polyneuropathy. The exact cause of the GBS is unclear but the main mechanism of behindis the demyelination of nerves especially the motor, sensory, and autonomic nerves which can be triggered by any immunologic or infectious agent. The infectious agent elicits the humoral and cellular mediated immune response due to their molecular mimicry in which the antibodies created against the infection matches with the proteins on the nerve. The characteristic features of Guillain–Barré syndrome are ascending flaccid paralysis, paresthesia, impairment of muscle reflexes, respiratory failureetc. The GBS is diagnosed via nerve conduction studies, lumbar puncture (Cerebrospinal fluid analysis), electromyography, Brighton criteria. Treatments like intravenous immunoglobulin therapy, plasma exchange can ease the symptoms and reduce the duration of the illness. This case report focusing on a 43-year-old female patient admitted seeking ventilatory support for respiratory distress caused by Guillain–Barré Syndrome in a tertiary hospital. Patient had developed limb weakness with ascending paralysis along with facial weakness within a couple of weeks after receiving the COVID -19 vaccination (COVISHIELD)one month back. Patient underwent nerve conduction study and routine monitoring of vital parameters. After conservative management with physiotherapy, ventilation, intravenous immunoglobulins and prophylaxis for pain and DVT patient gradually started improving the muscle power and was discharged to continue the rehabilitation care at home.

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