scholarly journals Child with Guillain-Barré Syndrome Responding to Plasmapheresis: A Case Report

2020 ◽  
Vol 3 (1) ◽  
pp. 4-11
Author(s):  
Sarmad Al Hamdani ◽  
Fatema Yusuf Aljanabi ◽  
Maryam Isa Abdulrasool ◽  
Alaa Haitham Salman
Keyword(s):  
Axonal Neuropathy ◽  
Cranial Nerves ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Upper Limbs ◽  
Acute Motor Axonal Neuropathy ◽  
Guillain Barré Syndrome ◽  
Foley’S Catheter ◽  
Guillain Barré ◽  
First Session

Intravenous immunoglobulin (IVIG) has long been regarded as the first-line treatment for Guillain-Barré syndrome (GBS), with plasmapheresis only being reserved for severe cases or used as an additional therapy of unproven efficacy. Here, we present the case of a 9-year-old girl with acute motor axonal neuropathy (AMAN), a rapidly progressive subtype of GBS that caused her to fall into respiratory failure. The patient failed to show a response 10 days after starting IVIG, but showed rather quick improvement with plasmapheresis. She received a total of 5 sessions of plasmapheresis on alternate days over a course of 8 days. Before starting plasmapheresis, her muscle strength was 2/5 in both upper limbs and 1/5 in both lower limbs, and she was dependent on mechanical ventilation. Following the first session, her power improved from 2/5 to 4/5 in the upper limbs, and the gag and sucking reflexes were recovered. On day 3, after the second session was initiated, she was extubated successfully (having been on a ventilator for 2 weeks) and remained on continuous positive airway pressure for the next 48 h, after which she was on room air. In addition, she was having hypertension from the first day of the diagnosis (which was due to autonomic instability), which improved after clonidine to maintain her blood pressure. She was also initially having urinary retention, then was off Foley’s catheter. The patient was discharged from the hospital 2 weeks following the first session of plasmapheresis, with power grade 4/5 in both her upper and lower limbs. Her cranial nerves had recovered fully, and she was able to walk with aids.

scholarly journals Guillain–Barré Syndrome Associated with SARS-CoV-2 Infection in a Pediatric Patient

2020 ◽  
Author(s):  
Carlos Henrique Michiles Frank ◽  
Taynná Vernalha Rocha Almeida ◽  
Elyana Almeida Marques ◽  
Quezia de Sousa Monteiro ◽  
Pablo Vinícius Silveira Feitoza ◽  
...  
Keyword(s):  
Axonal Neuropathy ◽  
Young Patients ◽  
Rapid Test ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Nasopharyngeal Swab ◽  
Acute Motor Axonal Neuropathy ◽  
Neurologic Manifestation ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Abstract We report the case of a 15-year-old male patient presenting frontal headaches with retro-orbital pain accompanied by fever evolving to weakness and pain of the lower limbs, which ascended to upper limbs. A COVID-19 rapid test (IgG and IgM) and nasopharyngeal swab polymerase chain reaction (PCR) was positive for SARS-CoV-2. The blood tests, cerebral spinal fluid (CSF) analysis and CSF aerobic culture revealed no abnormalities. PCR testing of the CSF was negative for the most prevalent etiologies as well as for SARS-CoV-2. Electroneurography study was compatible with the acute motor axonal neuropathy variant of Guillain–Barré syndrome. No cases involving young patients have been presented to date. Therefore, this is the first reported pediatric case of SARS-CoV-2 infection associated with GBS. Evidence reveals that SARS-CoV-2 infection is not limited to the respiratory tract. Neurotropism could explain this important neurologic manifestation of COVID-19 in children.

scholarly journals Electrophysiology in the Guillain-Barré Syndrome: Study of 30 Cases

1970 ◽  
Vol 24 (2) ◽  
pp. 54-60
Author(s):  
NC Kundu
Keyword(s):  
Cell Count ◽  
Electrophysiological Study ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Elevated Protein ◽  
Guillain Barré Syndrome ◽  
A Cell ◽  
Guillain Barré

Thirty consecutive patients diagnosed clinically as Guillain Barré Syndrome (GBS) were enrolled in this study to see the electrophysiological patterns of GBS in Bangladeshi community. Among 30 patients, 25 were male (M: F = 5:1) and 47% patients were between 16 and 25 years of age. An antecedent event was present in 67% of patients. An elevated protein was present in 90% of cases and a cell count of up to five was present in 94% of patients. Acute inflammatory demyelinating polyradiculopathy (AIDP) was commonest (33.35%) followed by acute motor axonal neuropathy (AMAN) which constitute 26% of patients in electrophysiological study of the enrolled patients. Acute motor sensory axonal neuropathy constitutes 14% of cases in this series. (J Bangladesh Coll Phys Surg 2006; 24: 54-60)

Acute Motor Axonal Neuropathy in a 5-Month-Old Child

2019 ◽  
Vol 18 (03) ◽  
pp. 171-174
Author(s):  
Federica Sullo ◽  
Milena Motta ◽  
Pierluigi Smilari ◽  
Luigi Rampello ◽  
Filippo Greco ◽  
...  
Keyword(s):  
Axonal Neuropathy ◽  
Male Infant ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Fisher Syndrome ◽  
Acute Inflammatory Demyelinating Polyneuropathy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Prior Infection ◽  
Prevalent Form

AbstractGuillain–Barré syndrome (GBS) is an acute inflammatory polyneuropathy characterized by rapidly progressive, essentially symmetric weakness and areflexia in a previously otherwise healthy child. It is the most common cause of acute flaccid paralysis in children, and its reported incidence is 1 to 2/100,000 population. Prior infection is a well-established predating event in GBS. The commonly recognized variants of GBS are acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor sensory axonal neuropathy, and Miller–Fisher syndrome. AIDP is the most prevalent form. As Guillain–Barrè syndrome represents an important differential diagnosis in infancy with pronounced and progressive hypotonia, we herein report a case of AMAN in a 5-month-old male infant without known exposure to immunomodulating factors or infections.

The acute motor-sensory axonal neuropathy variant of Guillain-Barré syndrome after thoracic spine surgery

2011 ◽  
Vol 15 (6) ◽  
pp. 605-609 ◽  
Author(s):  
Jocelyn Cheng ◽  
D. Ethan Kahn ◽  
Michael Y. Wang
Keyword(s):  
Spine Surgery ◽  
Thoracic Spine ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
Classic Form ◽  
Guillain Barré ◽  
New Onset

Guillain-Barré syndrome (GBS) is the eponym used to describe acute inflammatory polyradiculoneuropathies, which manifest with weakness and diminished reflexes. Although the classic form of GBS is considered to be an ascending demyelinating polyneuropathy, several variants have been described in the literature, including the Miller-Fisher syndrome, acute panautonomic neuropathy, acute motor axonal neuropathy, and acute motor-sensory axonal neuropathy (AMSAN). Few cases of postoperative GBS have been documented, particularly for the AMSAN variant. The authors describe the case of a patient who developed AMSAN after thoracic spine surgery and highlight the importance of investigating new-onset weakness in the postoperative period.

scholarly journals Electrophysiological patterns in patient with Guillain-Barre syndrome

2021 ◽  
Vol 12 (1) ◽  
pp. 16-21
Author(s):  
SM Monowar Hossain ◽  
Zahed Ali ◽  
Mohammad Motiur Rahman ◽  
Md Aolad Hossain ◽  
Pallab Kanti Saha ◽  
...  
Keyword(s):  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Axonal Neuropathy ◽  
Clinical Findings ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Cross Sectional ◽  
Female Ratio ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

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

Acute motor axonal neuropathy form of the Guillain Barre syndrome two months after bariatric surgery

2019 ◽  
Vol 48 (6) ◽  
pp. 725-727 ◽  
Author(s):  
Bouattour Nadia ◽  
Farhat Nouha ◽  
Sakka Salma ◽  
Dammak Mariem ◽  
Boujelbene Mohamed Salah ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

scholarly journals Guillain–Barre Syndrome in Postpartum Period: Rehabilitation Issues and Outcome – Three Case Reports

2017 ◽  
Vol 08 (03) ◽  
pp. 475-477 ◽  
Author(s):  
Anupam Gupta ◽  
Maitreyi Patil ◽  
Meeka Khanna ◽  
Rashmi Krishnan ◽  
Arun B. Taly
Keyword(s):  
Postpartum Period ◽  
Case Reports ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Neurological Rehabilitation ◽  
Acute Motor Axonal Neuropathy ◽  
First Case ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Time Of Admission

ABSTRACTWe report three females who developed Guillain–Barre Syndrome in postpartum period (within 6 weeks of delivery) and were admitted in the Neurological Rehabilitation Department for rehabilitation after the initial diagnosis and treatment in the Department of Neurology. The first case, axonal variant (acute motor axonal neuropathy [AMAN]) had worst presentation at the time of admission, recovered well by the time of discharge. The second case, acute motor sensory axonal neuropathy variant and the third case, AMAN variant presented at the late postpartum period. Medical treatment was sought much later due to various reasons and both the patients had an incomplete recovery at discharge. Apart from their presentations, rehabilitation management is also discussed in some detail.

Atypical Clinical Presentations of Pediatric Acute Immune-Mediated Polyneuropathy

2019 ◽  
Vol 34 (5) ◽  
pp. 268-276 ◽  
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.

scholarly journals Guillain-Barré syndrome in a child with COVID-19 associated multi system inflammatory syndrome

2021 ◽  
Vol 8 (11) ◽  
pp. 1890
Author(s):  
Alekhya Erubothu ◽  
Sudha Rudrappa ◽  
Pratibha Manjunath Patagar
Keyword(s):  
Axonal Neuropathy ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
High Grade Fever ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Paediatric Age ◽  
Guillain Barré ◽  
High Index Of Suspicion ◽  
Inflammatory Syndrome

Multi-system inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 is a new entity affecting a small percentage of children during the COVID-19 pandemic. This usually presents with multi-organ dysfunction, predominantly affecting cardiovascular, muco-cutaneous, and gastrointestinal systems. Till now, neurological manifestations as a part of this spectrum, such as, encephalopathy, inflammatory CNS syndromes, cerebrovascular disease, and Guillain-Barré syndrome (GBS), have been well reported in adults, but there is a paucity of data from the paediatric age group. Here, we present a case of a 6-year-old girl who presented to us with progressive, bilaterally symmetrical ascending weakness of lower limbs followed by upper limbs along with drooling of saliva and dyspnea. Nerve conduction studies showed motor axonal neuropathy suggestive of GBS and child was treated accordingly with intravenous immunoglobulin. On 4th day of admission, the child developed high grade fever spikes, hypotension and diarrhoea. Hence, worked up for MIS-C which revealed elevated inflammatory markers with positive SARS-CoV-19 IgM, IgG antibodies. The diagnosis was hence revised to GBS with MIS-C, the child was then started on methylprednisolone following which the child showed both clinical and biochemical improvement and was then discharged. A high index of suspicion for the possibility of MIS-C should be kept in mind in the present pandemic times, as the immune-mediated damages in MIS-C are potentially treatable with a timely institution of intensive care measures along with the use of steroids, IV-Ig, and plasmapheresis.

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