scholarly journals Diagnosis and management of Guillain–Barré syndrome in ten steps

2019 ◽  
Vol 15 (11) ◽  
pp. 671-683 ◽  
Author(s):  
Sonja E. Leonhard ◽  
Melissa R. Mandarakas ◽  
Francisco A. A. Gondim ◽  
Kathleen Bateman ◽  
Maria L. B. Ferreira ◽  
...  
Keyword(s):  
Early Recognition ◽  
French Polynesia ◽  
Guillain Barre Syndrome ◽  
Intensive Care Unit Treatment ◽  
Diagnosis And Management ◽  
Immune Mediated ◽  
Management Of Complications ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Progression Prediction

Abstract Guillain–Barré syndrome (GBS) is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. The incidence of GBS can therefore increase during outbreaks of infectious diseases, as was seen during the Zika virus epidemics in 2013 in French Polynesia and 2015 in Latin America. Diagnosis and management of GBS can be complicated as its clinical presentation and disease course are heterogeneous, and no international clinical guidelines are currently available. To support clinicians, especially in the context of an outbreak, we have developed a globally applicable guideline for the diagnosis and management of GBS. The guideline is based on current literature and expert consensus, and has a ten-step structure to facilitate its use in clinical practice. We first provide an introduction to the diagnostic criteria, clinical variants and differential diagnoses of GBS. The ten steps then cover early recognition and diagnosis of GBS, admission to the intensive care unit, treatment indication and selection, monitoring and treatment of disease progression, prediction of clinical course and outcome, and management of complications and sequelae.

Wernicke’s encephalopathy post hyperemesis gravidarum misdiagnosed as Guillain-Barre syndrome: lessons for the frontline

2021 ◽  
Vol 14 (3) ◽  
pp. e239977
Author(s):  
Kaushiki Kirty ◽  
Yashendu Sarda ◽  
Annu Jacob ◽  
Delanthabettu Venugopala
Keyword(s):  
Pregnant Woman ◽  
Hyperemesis Gravidarum ◽  
Early Recognition ◽  
Wernicke’S Encephalopathy ◽  
Guillain Barre Syndrome ◽  
Neurological Deficits ◽  
Wernicke's Encephalopathy ◽  
Motor Neuropathy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

We report a case of a 26-year-old pregnant woman, who presented with subacute limb weakness. This was initially suspected to be Guillain-Barre syndrome but subsequently found to be the motor neuropathy of dry beriberi (vitamin B1, thiamine deficiency) along with associated Wernicke’s encephalopathy (WE). The underlying cause was revealed as hyperemesis gravidarum (HG). HG complicates up to 3% of pregnancies and if severe, without nutritional supplements, may lead to electrolyte disturbances, calorie loss and vitamin deficiency. Although the association of HG and WE was first reported in 1939, it remains an under diagnosed condition with potential for serious and permanent neurological deficits, and some mortality, in both mother and baby. Early recognition of the problem, with timely and careful fluid, electrolyte, glucose and vitamin replacement is needed to avoid complications. We highlight current best practice in the treatment of WE. An open mind to the possibility of HG complications in any pregnant woman presenting with neurological symptoms is probably the most important lesson to learn from the front line.

scholarly journals Reworsening of Recurrent Guillain-Barré Syndrome Triggered by COVID-19 Infection

2021 ◽  
Vol 15 (1) ◽  
pp. 48-51
Author(s):  
Gian Luca Vita ◽  
Carmen Terranova ◽  
Maria Sframeli ◽  
Antonio Toscano ◽  
Giuseppe Vita
Keyword(s):  
Viral Infection ◽  
Neurological Diseases ◽  
Intravenous Immunoglobulins ◽  
Guillain Barre Syndrome ◽  
Case Presentation ◽  
Appropriate Treatment ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Introduction: Guillain-Barré Syndrome (GBS) is an acute, immune-mediated, generalized polyradiculoneuropathy often triggered by a bacterial or viral infection, vaccination, or surgery. During the SARS-CoV-2 pandemic, some patients were reported with GBS associated COVID-19 infection. Case Presentation: We report, herein, a patient who had a recurrent GBS after forty years. Intravenous immunoglobulins (IVIg) induced improvement, but her condition worsened suddenly after twenty days, coinciding with a COVID-19 infection. A second IVIg cycle was administered, and she improved again. Conclusion: The take-home message is that in the current pandemic, any re-worsening or lack of improvement after appropriate treatment of GBS or possibly other autoimmune neurological diseases must be checked to determine if it is related to COVID-19 infection.

scholarly journals Colistin neurotoxicity mimicking Guillain-Barré syndrome in a patient with cystic fibrosis: case report and review

2021 ◽  
Vol 2021 (9) ◽  
Author(s):  
Celeste Camargo ◽  
Tathagat Narula ◽  
Daniel A Jackson ◽  
Teresa Padro ◽  
W David Freeman
Keyword(s):  
Cystic Fibrosis ◽  
Drug Toxicity ◽  
Clinical Presentation ◽  
Guillain Barre Syndrome ◽  
Drug Induced ◽  
Common Presentation ◽  
Intravenous Treatment ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

ABSTRACT Guillain-Barré syndrome (GBS) is an immune-mediated polyneuropathy, which is characterized by areflexia and ascending paresthesia which can progress to a respiratory failure. Certain conditions, such as vasculitis and heavy metal and drug toxicity, may have misleadingly similar clinical presentation to GBS. We describe a case of a patient with cystic fibrosis and intravenous colistin-induced neurotoxicity mimicking GBS. The patient had used inhaled colistin on five occasions with no adverse effects, however, developed symptoms on the second day of intravenous treatment. Overlapping findings between immune-mediated polyneuropathy and drug-induced neurotoxicity include limb paresthesia and decreased reflexes. Perioral tingling, however, is a common presentation of colistin-induced neurotoxicity, and therefore, is an important differentiating factor. Early diagnosis prevents further neurologic decline, extensive unnecessary workup and potentially harmful incorrect management.

scholarly journals Patients’ experiences and perceptions of Guillain-Barré syndrome: A systematic review and meta-synthesis of qualitative research

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245826
Author(s):  
Despina Laparidou ◽  
Ffion Curtis ◽  
Joseph Akanuwe ◽  
Jennifer Jackson ◽  
Timothy L. Hodgson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Guillain Barre Syndrome ◽  
Link Type ◽  
Immune Mediated ◽  
Acceptable Quality ◽  
Guillain Barré Syndrome ◽  
Internet Searches ◽  
Guillain Barré ◽  
Full Text Screening

Background Guillain-Barré syndrome (GBS) is an immune-mediated polyradiculoneuropathy, with an incidence of 1-2/100,000 per year. Its severity is variable, ranging from very mild cases with brief weakness to severe paralysis, leading to inability to breathe independently, or even death. Currently there is limited evidence exploring the experiences of GBS patients. The aim of this study was to review patients’ experiences and perceptions of GBS and its variants at diagnosis, discharge and during recovery, by conducting a systematic review and thematic meta-synthesis of qualitative studies of patients’ experiences of GBS (and its variants). Methods We searched twelve electronic databases, supplemented with internet searches and forward and backward citation tracking from the included studies and review articles. Data were synthesised thematically following the Thomas and Harden approach. The CASP Qualitative Checklist was used to assess the quality of the included studies of this review. Results Our search strategy identified a total of 5,282 citations and after removing duplicates and excluding citations based on title and abstract, and full-text screening, five studies were included in the review and meta-synthesis; all included studies were considered of acceptable quality. Through constant discussions and an iterative approach, we developed six analytical themes following a patient’s journey from suspecting that they had a health problem, through to being hospitalised, experiencing ongoing difficulties, slowly recovering from GBS, adjusting to their new circumstances, and re-evaluating their lives. Conclusions Despite the variety of experiences, it was evident from all included studies that being diagnosed with and surviving GBS was a life-changing experience for all participants. Trial registration Protocol was registered (CRD42019122199) on the International Prospective Register of Systematic Reviews (http://www.crd.york.ac.uk/PROSPERO).

Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Pregnancy

2018 ◽  
Author(s):  
Pariwat Thaisetthawatkul ◽  
Eric Logigian
Keyword(s):  
Fetal Outcome ◽  
Chronic Inflammatory Demyelinating Polyradiculoneuropathy ◽  
Guillain Barre Syndrome ◽  
Progressive Muscle Weakness ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Viral Illness ◽  
Life Threatening ◽  
Depolarizing Agents ◽  
Guillain Barré

Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are both immune-mediated diseases of the peripheral nervous system that typically present with symmetric, progressive muscle weakness, areflexia, and sensory symptoms or signs. GBS evolves rapidly with a nadir at 2–4 weeks usually with an antecedent viral illness, while CIDP progresses more slowly over months to years. GBS is sometimes complicated by life-threatening respiratory failure or dysautonomia. Onset of GBS and relapse of CIDP can occur during pregnancy or postpartum. But with appropriate supportive care and immunotherapy, maternal and fetal outcome in both conditions is typically excellent. The exception is fetal outcome in GBS triggered by maternal CMV or Zika infection transmitted to the fetus. Full-term vaginal delivery and regional anesthesia are preferred in maternal GBS and CIDP, but if C-section and general anesthesia are indicated, non-depolarizing agents such as succinylcholine should be avoided.

Two success stories in the management of Guillain–Barré syndrome illustrate the challenges of intensive care unit care in Malawi

2020 ◽  
pp. 004947552096275
Author(s):  
Lauren Onofrey ◽  
Claire Naus ◽  
Kiran T Thakur ◽  
Clement Kadyaudzu ◽  
Meghan Prin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Early Recognition ◽  
Tertiary Hospital ◽  
Guillain Barre Syndrome ◽  
Intensive Care Unit Care ◽  
Low Resource ◽  
Success Stories ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

The management of critical illness is especially challenging in low-resource environments, and early recognition and supportive care are essential, regardless of the ability to employ advanced or invasive therapy. In this report, we discuss two patients with Guillain–Barré syndrome who were managed successfully in the intensive care unit of a tertiary hospital in Malawi. Both patients recovered and were discharged home. The management and outcomes of these patients provide case-based lessons for improving intensive care unit medicine in low-resource contexts.

Sign in / Sign up

Export Citation Format

Share Document