Correlation of nerve ultrasound, electrophysiological, and clinical findings in post Guillain-Barré syndrome

Background: Guillain-Barre syndrome (GBS) is an acute, frequently severe and fulminant polyradiculoneuropathy that is autoimmune in nature. Incidence and predominant subtypes of GBS differ geographically. Electrophysiology has important role in subtyping GBS. This study aimed to evaluate the electrophysiological findings in patient of GBS. Methods: This was a hospital based cross-sectional descriptive study and conducted at the Department of Neurology in Sir Salimullah Medical College & Mitford Hospital, Dhaka and National Institute of Neurosciences and Hospital, Dhaka during July 2017 to June 2018. Clinically diagnosed 53 patients with GBS were enrolled according to prefixed selection criteria. Detail history taking, clinical examination, nerve conduction study and cerebrospinal fluid (CSF) examination was performed in all cases. Clinical findings, nerve conduction study (NCS) parameters, CSF findings and demographic profiles were evaluated. Results: Mean ± SD age of presentation was 41.64 (±14.56) years and median age was 42.0 years. There were total 33(62 %) males and 20 (38 %) females with male: female ratio of 1.7:1. Clinically two-thirds(62.3%) of patients had both upper and lower limb involvement (62.3%), facial weakness was in 32.1% and 13.2% had bulbar involvement. Acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN)were found to be 51%, 32% and 17% respectively. CSFprotein was elevated in most of the patients with a range of 16-725 mg/dl. Highest CSF protein was found in AIDP. Conclusion: Electrophysiological studies play an important role in the early detection; characterization of GBS.In this study, the commonest type of GBS was AIDP. Higher levels of CSF protein, absent H-reflex and Fresponse, sural sparing and unexcitable nerves are more frequently present in AIDP. BIRDEM Med J 2022; 12(1): 16-21

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Acute inflammatory demyelinating polyradiculoneuropathy (Guillain-Barré syndrome) following dengue fever

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652011000400009 ◽

2011 ◽

Vol 53 (4) ◽

pp. 223-225 ◽

Cited By ~ 12

Author(s):

Eduardo Gonçalves

Keyword(s):

Female Child ◽

Clinical Findings ◽

Guillain Barre Syndrome ◽

Clinical Image ◽

Biochemical Tests ◽

Peripheral Facial Palsy ◽

Guillain Barré Syndrome ◽

Electrophysiological Findings ◽

Laboratory Examinations ◽

Guillain Barré

This paper reports a case of dengue in a six-year-old female child who suddenly developed excruciating headaches, fever, myalgia and paresis. Laboratory examinations included blood count, platelet count, biochemical tests (BUN, creatinine, aminotransferases, and total bilirubin and bilirubin fractions) and specific IgM titers (enzyme-immunoassay with recombinant tetravalent dengue). After ten days of hospitalization and having already been in a home environment, a new clinical image emerged, characterized by dysphagia, dysphonia, weakness, peripheral facial palsy and paresthesia. The diagnosis of Guillain-Barré Syndrome was based on clinical findings, cerebrospinal fluid examination, electrophysiological findings and the exclusion of other pathologies. Our case, as some shown in previous reports, calls attention to the possibility that Guillain-Barré Syndrome may occur in association with dengue.

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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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Hyperreflexia ? an Uncommon Presentation of Guillain-Barré Syndrome

Journal of Enam Medical College ◽

10.3329/jemc.v7i2.32658 ◽

2017 ◽

Vol 7 (2) ◽

pp. 111-112

Author(s):

NS Neki ◽

Gagandeep Singh Shergill ◽

Amanpreet Kaur

Keyword(s):

Cerebrospinal Fluid ◽

Nerve Conduction Study ◽

Clinical Findings ◽

Acute Onset ◽

Guillain Barre Syndrome ◽

Motor Weakness ◽

Uncommon Presentation ◽

Guillain Barré Syndrome ◽

Guillain Barré ◽

European Populations

Guillain-Barré syndrome (GBS) is an acquired acute autoimmune polyradiculoneuropathy. Progressive motor weakness and areflexia are essential for diagnosis. But in some cases hyperreflexia can be seen. Diagnosis of GBS was made based on history and clinical findings and was supported by cerebrospinal fluid (CSF) studies and nerve conduction study (NCS). We hereby report a case of a 42-year-old male presenting with acute onset flaccid quadriparesis. There was frank hyperreflexia in all four limbs. Although reflex preservation and hyperreflexia can be noted in axonal variant of GBS in Chinese, Japanese, and European populations, it is uncommon in India.J Enam Med Col 2017; 7(2): 111-112

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Atypical Clinical Presentations of Pediatric Acute Immune-Mediated Polyneuropathy

Journal of Child Neurology ◽

10.1177/0883073818825213 ◽

2019 ◽

Vol 34 (5) ◽

pp. 268-276 ◽

Cited By ~ 2

Author(s):

Naama Yosha-Orpaz ◽

Sharon Aharoni ◽

Malcolm Rabie ◽

Yoram Nevo

Keyword(s):

Axonal Neuropathy ◽

Significant Proportion ◽

Respiratory Muscles ◽

Clinical Findings ◽

Guillain Barre Syndrome ◽

Acute Motor Axonal Neuropathy ◽

Presenting Symptoms ◽

Tertiary Center ◽

Guillain Barré Syndrome ◽

Guillain Barré

Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis in children. During the acute phase, the disorder can be life-threatening by involving the respiratory muscles and the autonomic nervous system. Nevertheless, the prognosis is good, and most children achieve full recovery. The aim of this study was to characterize the clinical and electrophysiologic findings in children with Guillain-Barré syndrome referred to a tertiary center in Israel. A retrospective database review from 2009 to 2015 identified 39 children. Data on clinical presentation, respiratory complications, and long-term neurologic outcomes were collected. Atypical clinical findings at admission included asymmetric weakness in 23%, nonascending weakness in 30%, and normal deep tendon reflexes in 28%. Eight children were later diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Electrophysiologic findings, available in 12 patients with Guillain-Barré syndrome, revealed acute inflammatory demyelinating polyradiculoneuropathy (AIDP) in 4 (33.5%), AIDP with secondary axonal changes in 3 (25%), and acute motor axonal neuropathy (AMAN) subtype in 4 (33.5%); 8% had no abnormal findings. On follow-up, 71% of the children with Guillain-Barré syndrome fully recovered compared to 14% of the children with CIDP. Corresponding rates of neurologic sequelae were 29% and 86%. Clinicians should be alert to the atypical presenting symptoms of Guillain-Barré syndrome, which occur in a significant proportion of children.

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Swollen nerves slimming: Sequential nerve ultrasound in acute Guillain–Barré syndrome

Clinical Neurophysiology ◽

10.1016/j.clinph.2015.07.010 ◽

2016 ◽

Vol 127 (2) ◽

pp. 1013-1014 ◽

Cited By ~ 3

Author(s):

Einar P. Wilder-Smith

Keyword(s):

Guillain Barre Syndrome ◽

Nerve Ultrasound ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Case 23

10.1093/med/9780190603434.003.0027 ◽

2018 ◽

Author(s):

Bashar Katirji

Keyword(s):

Axonal Neuropathy ◽

Recovery Phase ◽

Clinical Findings ◽

Guillain Barre Syndrome ◽

Acute Motor Axonal Neuropathy ◽

Fisher Syndrome ◽

Immune Mediated ◽

Guillain Barré Syndrome ◽

Diagnostic Sensitivity And Specificity ◽

Guillain Barré

Guillain-Barré syndrome is the prototype of acute immune-mediated neuropathies. Guillain-Barré syndrome has several subtypes including acute inflammatory demyelinating polyneuropathy, acute motor axonal neuropathy, and acute motor sensory axonal neuropathy. Guillain-Barré syndrome has also several variants including Miller Fisher syndrome, ataxic form, and pharyngeal–cervical–brachial form. This case highlights the clinical findings in Guillain-Barré syndrome and discusses in details the diagnostic criteria that are essential in confirming the diagnosis and excluding mimickers of the disorder. This is followed by a detailed discussion on the electrodiagnostic findings in Guillain-Barré syndrome during the acute presentation and recovery phase. The diagnostic sensitivity and specificity of the various findings seen on nerve conduction studies are included.

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