scholarly journals Guillain-Barre Syndrome following COVID-19 Infection: First Case Report from Kuwait and Review of the Literature

2021 ◽  
pp. 1-5
Author(s):  
Walaa A. Kamel ◽  
Ismail Ibrahim Ismail ◽  
Jasem Yousef Al-Hashel

Objective: Guillain-Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy that is often related to a previous infectious exposure. GBS emerged as a potentially serious complication of coronavirus disease 2019 (COVID-19) since its declaration as a global pandemic. We report the first case from Kuwait, to the best of our knowledge. Clinical Presentation: A 72-year-old male presented with 3 weeks history of acute progressive and ascending lower limbs weakness. He developed these symptoms 3 weeks after testing positive to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Electrophysiological studies showed acute demyelinating polyradiculoneuropathy and cerebrospinal fluid showed protein-cell dissociation. He was successfully treated with intravenous immunoglobulins (IVIGs). Conclusion: Neurologists should be aware of GBS as a potentially serious complication associated with CO­VID-19. Our patient had a favorable outcome with IVIG with no autonomic or respiratory affection.

2021 ◽  
Vol 14 (6) ◽  
pp. e243629
Author(s):  
Tanveer Hasan ◽  
Mustafizur Khan ◽  
Farhin Khan ◽  
Ghanim Hamza

Guillain-Barré syndrome (GBS) is a rare immune-mediated disorder of the peripheral nerves. Although its cause is not fully understood, the syndrome often follows infection with a virus or bacteria, although in rare occasions, vaccination may precede GBS. We describe a case of a 62-year-old woman who presented with paraesthesia and progressive weakness of both lower limbs over 3 days. Clinical examination and investigation findings including lumbar puncture and nerve conduction studies were consistent with the diagnosis of GBS. She had no history of either diarrhoea or respiratory tract infections preceding her presentation. However, she had her first intramuscular dose of the Oxford/AstraZeneca COVID-19 vaccine 11 days prior to her presentation. Although no direct link could be ascertained, the purpose of this report is to highlight the incidence and consider this issue while evaluating any case of GBS in the light of the current pandemic and vaccination programme.


2020 ◽  
Author(s):  
Nuvia Mackenzie ◽  
Eva Lopez-Coronel ◽  
Alberto Dau ◽  
Dieb Maloof ◽  
Salvador Mattar ◽  
...  

Abstract Background: During the COVID-19 pandemic, different neurological manifestations have been published. However, few cases of Guillain-Barre Syndrome and COVID-19 have been reported. We describe a concomitant Guillain-Barre Syndrome and COVID-19 patient.Case presentation: a 39 years old woman was admitted in a teaching hospital in Barranquilla, Colombia with a history of progressive general weakness with lower limb dominance. A previous symptom as ageusia, anosmia and intense headache was reported. On admission, facial diplegia, quadriparesis with lower limbs predominance and Medical Research Council Scale 2/5 in lower limbs and 4/5 in upper limbs was reported. During clinical evolution, due to general areflexia, hypertensive emergency and progressive diaphragmatic weakness, the patient was admitted to intensive care unit. Cerebrospinal Serum Fluid revealed protein-cytologic dissociation and electromyography test were compatible with Guillain-Barre Syndrome. By symptoms before hospitalization, SARS-CoV2 diagnostic testing was performed with positive result in second test. Management to COVID-19 and Guillain Barre Syndrome was performed and patient was discharged after 20 days of hospitalization with clinical improvement.Conclusions: Few cases have been published reporting COVID-19 and Guillain-Barre Syndrome. We report the first confirmed case of COVID-19 with concomitant Guillain-Barre Syndrome in Colombia. In patients with Guillain-Barre Syndrome, several viral and bacterial pathogens have been found in case-control studies but there are do not clarity in what triggers the immune-mediated destruction of nerves. More studies are needed to determine possible association among COVID-19 exposure and Guillain-Barre Syndrome.


2021 ◽  
Vol 15 (1) ◽  
pp. 48-51
Author(s):  
Gian Luca Vita ◽  
Carmen Terranova ◽  
Maria Sframeli ◽  
Antonio Toscano ◽  
Giuseppe Vita

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.


Author(s):  
Navid Manouchheri ◽  
Omid Mirmosayyeb ◽  
Majid Ghasemi ◽  
Shervin Badihian ◽  
Vahid Shaygannejad ◽  
...  

Introduction: Guillain-Barre Syndrome is an uncommon complication during acute brucellosis. Case presentation: In this study, we present a case of Guillain-Barre Syndrome in a 22-year old male patient with complaints of weakness in his lower limbs. He had a history of acute Brucella infection for four months and received antimicrobial medication. Conclusion: the patients can be affected by GBS after antimicrobial treatment.


BMC Neurology ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Masako Fujita ◽  
Tatsuya Ueno ◽  
Michiru Horiuchi ◽  
Tatsuro Mitsuhashi ◽  
Shouji Yamamoto ◽  
...  

Abstract Background Guillain–Barré syndrome (GBS) and spinal epidural abscess (SEA) are known as mimics of each other because they present with flaccid paralysis following an infection; however, they differ in the main causative bacteria. Nevertheless, the two diseases can occur simultaneously if there is a preceding Campylobacter infection. Here, we report the first case of SEA with GBS following Campylobacter coli infection. Case presentation A 71-year-old Japanese man presented with progressive back pain and paralysis of the lower limbs following enteritis. Magnetic resonance imaging showed a lumbar epidural abscess that required surgical decompression; therefore, surgical drainage was performed. Blood cultures revealed the presence of C. coli. Despite surgery, the paralysis progressed to the extremities. Nerve conduction studies led to the diagnosis of GBS. Anti-ganglioside antibodies in the patient suggested that GBS was preceded by Campylobacter infection. Intravascular immunoglobulin therapy attenuated the progression of the paralysis. Conclusions We report a case of SEA and GBS following Campylobacter infection. A combination of the two diseases is rare; however, it could occur if the preceding infection is caused by Campylobacter spp. If a cause is known but the patient does not respond to the corresponding treatment, it is important to reconsider the diagnosis based on the medical history.


Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 775
Author(s):  
Tomasz Chmiela ◽  
Michalina Rzepka ◽  
Ewa Krzystanek ◽  
Agnieszka Gorzkowska

Severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, causes acute respiratory disease (coronavirus disease 2019; COVID-19). However, the involvement of other mechanisms is also possible, and neurological complications are being diagnosed more frequently. Here, we would like to present a case of a Polish patient with Guillain–Barré syndrome (GBS), after a documented history of COVID-19: A 50-year-old man, 18 days after the onset of COVID-19 symptoms, had progressive quadriparesis preceded by 1-day sensory disturbances. Based on the clinical picture, the results of diagnostic work-up including a nerve conduction study (ENG) that revealed a demyelinating and axonal sensorimotor polyneuropathy, and cerebrospinal fluid (CSF) analysis that showed albumin–cytological dissociation, an acute inflammatory demyelinating polyneuropathy was confirmed, consistent with GBS. Upon a therapeutic plasma exchange (TPE), the patient’s condition improved. The presented case of GBS in a patient after mild COVID-19 is the first case in Poland that has supplemented those already described in the global literature. Attention should be drawn to the possibility of GBS occurring after SARS-CoV-2 infection, even when it has a mild course.


Author(s):  
Vinod John ◽  
Jiya Thankam Koshy ◽  
Nikhil Gladson ◽  
Vimod K. Wills

Several reports and studies are being conducted to this day based on the safety profile of COVID-19 vaccines. COVID-19 vaccination inducing GBS is a rare adverse effect and is likely to be causal. Though, there are reports concerning the relation between coronavirus infections and GBS, the pathogenic mechanism and relevant factors behind COVID-19 vaccines inducing GBS are still not being corroborated so far. Guillain-Barre syndrome is the principal cause of acute flaccid paralysis with a prevalence rate of 2 in 100, 000 people per year. We illustrate a 55 years old female patient who presented with acute onset paraesthesia and progressive weakness of bilateral lower limbs and gait imbalance of 5 days duration to the Hospital during the first week of September. Her symptoms occurred within 2 weeks of the first dose of the ChAdOx1-n-CoV-19 (Covishield) vaccine proving a major possibility of vaccine-induced neurological adverse effect as she didn't have any likely significant history of illness or allergies in the past rather than type 2 diabetes mellitus. This report aims to highlight the incidence and to ruminate upon this matter while evaluating any GBS cases in the current eras of the COVID-19 pandemic and vaccination.


2021 ◽  
Vol 8 (11) ◽  
pp. 1890
Author(s):  
Alekhya Erubothu ◽  
Sudha Rudrappa ◽  
Pratibha Manjunath Patagar

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.


2019 ◽  
Vol 49 (3) ◽  
pp. 248-249 ◽  
Author(s):  
Nishant Dev ◽  
Rahul Kumar ◽  
Dilip Kumar

Guillain–Barré syndrome (GBS) is a potentially life-threatening immune-mediated acute inflammatory polyneuropathy associated with several antecedent infections. We report a 20-year-old man with GBS associated with concurrent leptospirosis and scrub typhus infection. GBS was confirmed with clinical examination and nerve conduction studies. There have been case reports of GBS in association with Leptospira and Orienta tsusugamushi separately. However, this may be the first case report of GBS associated with concurrent diseases.


Author(s):  
Hemant Mahur ◽  
Kartikeya Mathur ◽  
D. P. Singh ◽  
Umesh Chahar ◽  
Darshan R. S. ◽  
...  

COVID-19 is a global pandemic which has varied array of symptoms. A neurotropic presentation has also been described of which the most common is stroke. In this brief communication we report a case of COVID-19 who presented to our hospital with features suggestive of Guillain-Barré syndrome. A 76 year old male presented with chief complains of weakness in both lower limbs. On detailed examination the patient had LMN type quadriparesis without sensory involvement. Diagnosis of GBS was confirmed by CSF and NCV studies and other cases of quadriparesis were ruled out by appropriate investigations and treatment of the same was started. Respiratory examination revealed bilateral basal crepitations and CXR revealed B/L lower zone haziness so a secondary diagnosis of B/L Atypical Pneumonitis suspected COVID-19 was kept. A COVID-19 RTPCR turned out to be negative initially. However, looking at respiratory signs and symptoms along with increase in inflammatory markers a repeat COVID RTPCR was planned which turned out to be positive. Patient was further managed on the line of COVID-19 pneumonitis. He responded well to the treatment and is now asymptomatic on follow up. Nervous system involvement in COVID-19 may have been grossly underestimated. Over the course of this pandemic, an increasing number of COVID-19 patients are being reported with neurological complications. Physicians should be aware of atypical presentation where patient complained of weakness first and had respiratory symptoms later as in our case where early detection of atypical presentations help in better management.


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