Case Series of Guillain-Barré Syndrome After the ChAdOx1 nCoV-19 (Oxford–AstraZeneca) Vaccine

2022 ◽  
pp. 10.1212/CPJ.0000000000001148
Author(s):  
Miranda Mengyuan Wan ◽  
Angela Lee ◽  
Ronak Kapadia ◽  
Christopher Hahn

AbstractPurposeof Review: Vaccination has been associated with Guillain-Barre Syndrome (GBS). Amidst a global vaccination campaign to stop the spread of COVID-19, fears of GBS can contribute to vaccine-hesitancy. We describe three cases of GBS in Calgary, Canada presenting within 2 weeks of receiving the ChAdOx1 nCoV-19 (COVISHIELD) Oxford-AstraZeneca vaccination and review the available literature.Recent Findings:All three patients presented to hospital in Calgary, Alberta, Canada within a one-month time frame with GBS. Their clinical courses ranged from mild to severe impairment, all requiring immunomodulatory treatment.Summary:There is currently little evidence to support a causal relationship between vaccination and GBS. Furthermore, there is limited evidence to support recurrent GBS in patients with GBS temporally associated with vaccination. Neurologists should approach discussions with patients regarding GBS after vaccination carefully, so as not to misrepresent this relationship, and to educate patients that the risk of COVID-19 infection outweighs the small individual risk of a vaccine-associated adverse event.

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 167
Author(s):  
Pasquale Sansone ◽  
Luca Gregorio Giaccari ◽  
Caterina Aurilio ◽  
Francesco Coppolino ◽  
Valentina Esposito ◽  
...  

Background. Guillain-Barré syndrome (GBS) is the most common cause of flaccid paralysis, with about 100,000 people developing the disorder every year worldwide. Recently, the incidence of GBS has increased during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemics. We reviewed the literature to give a comprehensive overview of the demographic characteristics, clinical features, diagnostic investigations, and outcome of SARS-CoV-2-related GBS patients. Methods. Embase, MEDLINE, Google Scholar, and Cochrane Central Trials Register were systematically searched on 24 September 2020 for studies reporting on GBS secondary to COVID-19. Results. We identified 63 articles; we included 32 studies in our review. A total of 41 GBS cases with a confirmed or probable COVID-19 infection were reported: 26 of them were single case reports and 6 case series. Published studies on SARS-CoV-2-related GBS typically report a classic sensorimotor type of GBS often with a demyelinating electrophysiological subtype. Miller Fisher syndrome was reported in a quarter of the cases. In 78.1% of the cases, the response to immunomodulating therapy is favourable. The disease course is frequently severe and about one-third of the patients with SARS-CoV-2-associated GBS requires mechanical ventilation and Intensive Care Unit (ICU) admission. Rarely the outcome is poor or even fatal (10.8% of the cases). Conclusion. Clinical presentation, course, response to treatment, and outcome are similar in SARS-CoV-2-associated GBS and GBS due to other triggers.


2015 ◽  
Vol 86 (11) ◽  
pp. e4.158-e4
Author(s):  
Catherine Morgan ◽  
Benjamin Wakerley ◽  
Geraint Fuller

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.


2016 ◽  
Vol 375 (16) ◽  
pp. 1598-1601 ◽  
Author(s):  
Thais dos Santos ◽  
Angel Rodriguez ◽  
Maria Almiron ◽  
Antonio Sanhueza ◽  
Pilar Ramon ◽  
...  

2017 ◽  
Vol 37 ◽  
pp. 19-23 ◽  
Author(s):  
Arturo Arias ◽  
Lilian Torres-Tobar ◽  
Gualberto Hernández ◽  
Deyanira Paipilla ◽  
Eduardo Palacios ◽  
...  

2021 ◽  
Vol 83 ◽  
pp. 119-122
Author(s):  
Meysam Abolmaali ◽  
Matineh Heidari ◽  
Marjan Zeinali ◽  
Parichehr Moghaddam ◽  
Mona Ramezani Ghamsari ◽  
...  

2014 ◽  
Vol 200 (6) ◽  
pp. 321-321
Author(s):  
Nigel W Crawford ◽  
Allen Cheng ◽  
Nick Andrews ◽  
Patrick G Charles ◽  
Hazel J Clothier ◽  
...  

2017 ◽  
Vol 381 ◽  
pp. 652 ◽  
Author(s):  
T. Mathew ◽  
K. Thomas ◽  
R. Nadig ◽  
S. Badachi ◽  
A. Awati ◽  
...  

2022 ◽  
Vol 7 (4) ◽  
pp. 326-333
Author(s):  
Madhavi Karri ◽  
Deepak Jacob ◽  
Balakrishnan Ramasamy ◽  
Santhosh Perumal

A novel coronavirus (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARs-CoV-2). This pandemic has been globally alarming in the current period. Several neurological manifestations are reported occurring with the infection. Guillain barre syndrome (GBS) or acute onset inflammatory polyradiculoneuropathy has been among the frequent manifestations observed among them. To know the pattern and outcome of GBS in COVID-19 affected individuals. We have taken six individuals admitted with flaccid quadriparesis in the last two months. All were affected recently by COVID 19 infection, which RT PCR of the nasopharyngeal swab confirmed. The study participants have undergone nerve conduction studies and have been diagnosed with Guillain Barre syndrome using Brighton criteria. We did cerebrospinal fluid (CSF) analysis after admission. We initiated all patients on Intravenous immunoglobulin according to body weight (2g/kg divided over five days). We used the Barthel index score to assess the outcome of the individuals. We observed a mean duration of 18.25 days between the COVID-19 infection and the onset of symptoms. Apart from motor quadriparesis and sensory symptoms being in common, we also noticed cranial nerves and autonomic involvement. We made the diagnosis using the nerve conduction studies and Brighton criteria. After initiating intravenous immunoglobulin, all patients had a good outcome, and quality of life was better after two months of follow up. Guillain Barre syndrome is one of the neurological manifestations of COVID-19 and has a dramatic response with intravenous immunoglobulin and better outcome with treatment.


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