Guillain-Barré Syndrome and COVID-19: Two Case Reports

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.

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Guillain Barre syndrome as a complication of SARS-CoV-2 infection: A case reports

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2021.102672 ◽

2021 ◽

pp. 102672

Author(s):

Ghizlane El aidouni ◽

Salma Touihar ◽

Mohammed Aabdi ◽

Manal Merbouh ◽

Abderrahim El Kaouini ◽

...

Keyword(s):

Case Reports ◽

Guillain Barre Syndrome ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Guillain-Barre Syndrome in a Case of Typhoid Fever: an Uncommon Association

Bangladesh Journal of Medicine ◽

10.3329/bjm.v32i2.53799 ◽

2021 ◽

Vol 32 (2) ◽

pp. 142-144

Author(s):

Abdul Basit Ibne Momen ◽

Furial Quraishi Twinkle ◽

Aminur Rahman ◽

Firoz Ahmed Quraishi

Keyword(s):

Case Report ◽

Blood Culture ◽

Typhoid Fever ◽

Intravenous Immunoglobulin ◽

Case Reports ◽

Neurological Complication ◽

Guillain Barre Syndrome ◽

Intravenous Antibiotics ◽

Guillain Barré Syndrome ◽

Guillain Barré

Guillain-Barre syndrome (GBS) following typhoid is extremely uncommon and only few case reports are available in literature. The importance of this case report is to highlight upon the fact that a diagnosis of GBS should always be kept in mind whenever a patient of typhoid fever develops weakness. We report a young girl with blood culture proven typhoid fever that developed this very rare neurological complication quite early in the course of the disease. Following treatment with intravenous antibiotics and intravenous immunoglobulin, she was improved. Bangladesh J Medicine July 2021; 32(2) : 142-144

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Fulminant Guillain-Barré syndrome post-hemorrhagic stroke: Two case reports

Journal of the Neurological Sciences ◽

10.1016/j.jns.2021.118796 ◽

2021 ◽

Vol 429 ◽

pp. 118796

Author(s):

Sameeh Abdulmana ◽

Naif Al-Zahrani ◽

Shahid Bashir ◽

Adnan Alsarawi ◽

Yahya Sharahely ◽

...

Keyword(s):

Hemorrhagic Stroke ◽

Case Reports ◽

Guillain Barre Syndrome ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Rapidly developing weakness mimicking Guillain-Barré syndrome in beriberi neuropathy: Two case reports

Nutrition ◽

10.1016/j.nut.2008.02.022 ◽

2008 ◽

Vol 24 (7-8) ◽

pp. 776-780 ◽

Cited By ~ 34

Author(s):

Haruki Koike ◽

Shinji Ito ◽

Saori Morozumi ◽

Yuichi Kawagashira ◽

Masahiro Iijima ◽

...

Keyword(s):

Case Reports ◽

Guillain Barre Syndrome ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Guillain Barré Syndrome and its variants as a manifestation of COVID-19: A systematic review of case reports and case series

Journal of the Neurological Sciences ◽

10.1016/j.jns.2020.117263 ◽

2021 ◽

Vol 420 ◽

pp. 117263

Author(s):

Shitiz Sriwastava ◽

Saurabh Kataria ◽

Medha Tandon ◽

Jenil Patel ◽

Riddhi Patel ◽

...

Keyword(s):

Systematic Review ◽

Case Reports ◽

Case Series ◽

Guillain Barre Syndrome ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Case Report: Acute Bulbar Palsy Plus Syndrome: A Guillain-Barré Syndrome Variant More Prone to Be a Subtype Than Overlap of Distinct Subtypes

Frontiers in Neurology ◽

10.3389/fneur.2020.566480 ◽

2020 ◽

Vol 11 ◽

Author(s):

Qian Cao ◽

Hong Chu ◽

Xiujuan Fu ◽

Jiajia Yao ◽

Zheman Xiao ◽

...

Keyword(s):

Facial Palsy ◽

Case Reports ◽

Cranial Nerves ◽

Case Series ◽

Guillain Barre Syndrome ◽

Bulbar Palsy ◽

Guillain Barré Syndrome ◽

Diagnostic Framework ◽

Accompanying Symptoms ◽

Guillain Barré

Objective: Acute bulbar palsy plus (ABPp) syndrome is a rare regional variant of Guillain-Barré syndrome (GBS) characterized by acute bulbar palsy combined with other cranial symptoms or ataxia without limb and neck weakness. We aim to investigate characteristics of ABPp syndrome and analyze its nosological position within the GBS spectrum.Methods: A patient with ABPp syndrome was reported, and previous case reports of patients who met the criteria for ABPp syndrome from the literature were reviewed.Results: A total of 28 patients were included in our study. Median age was 32 years. Most of the patients (78.6%) were from Asia, and 75.0% had preceding infection. The main accompanying symptoms were ophthalmoplegia (85.7%), facial palsy (60.7%), and ataxia (50.0%). There existed asymmetric weakness in the form of unilateral facial palsy (32.1%) and ptosis (3.6%). Approximately half of the patients had albuminocytological dissociation. All the tested patients were seropositive for antiganglioside antibodies, of which the two most common were immunoglobulin G (IgG) anti-GT1a (77.3%) and anti-GQ1b (59.1%) antibodies. Over one-third of the patients who underwent electrophysiological assessment showed subclinical neuropathy beyond cranial nerves. The outcome was generally favorable as 89.3% of patients made full recovery within 5 months.Conclusion: The hitherto largest case series of ABPp syndrome advances our understanding of this disease. Serologically, the presence of IgG anti-GT1a and anti-GQ1b antibodies predicts and contributes to the disease. Phenotypically, ABPp syndrome is more prone to be a separate subtype of GBS than overlap of distinct subtypes and has the potential to complement current diagnostic framework of GBS.

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

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_474_16 ◽

2017 ◽

Vol 08 (03) ◽

pp. 475-477 ◽

Cited By ~ 1

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.

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Transverse Myelitis and Guillain-Barré Syndrome Overlap Secondary to Bartonella henselae: Case Report

Prague Medical Report ◽

10.14712/23362936.2019.18 ◽

2019 ◽

Vol 120 (4) ◽

pp. 131-137

Author(s):

Jamir Pitton Rissardo ◽

Ana Letícia Fornari Caprara

Keyword(s):

Bartonella Henselae ◽

Case Reports ◽

Plantar Flexion ◽

Transverse Myelitis ◽

Guillain Barre Syndrome ◽

Simultaneous Occurrence ◽

Present Moment ◽

Serological Tests ◽

Guillain Barré Syndrome ◽

Guillain Barré

The GBS/ATM overlap is characterized by the simultaneous occurrence of Guillain-Barré syndrome (GBS) and acute transverse myelitis (ATM), which are two neurological autoimmune disorders. In this context, cat scratch disease (CSD) was rarely reported combined with this overlap. An adult female presenting fever, back pain, inferior limb weakness, and anuria was admitted to our hospital. On the physical exam, a distended bladder and bilateral lymphadenopathy were observed. The neurological assessment revealed muscle weakness, plantar flexion, and hyporeflexia in right with absence in left. Also, she reported hyperalgesia in inferior limbs. Her blood pressure was fluctuating being in the majority of the time hypertensive. A spinal cord MRI (magnetic resonance imaging) was suggestive of transverse myelitis. Methylprednisolone was started. The cerebrospinal fluid showed 37.0 cells/mm3 of white blood cell count, 49 mg/dl of glucose, and 50.7 mg/dl of protein. Ceftriaxone and vancomycin were started. On further questioning, the subject stated that her finger was bitten by a cat about two weeks before the beginning of the symptoms. Serological tests were positive for Bartonella henselae. Doxycycline and rifampin were started. After one-month, her symptoms improve but she continued with a radicular pain and weakness. An EMG (electroneuromyography) was suggestive of demyelination. IVIG (intravenous immunoglobulin) was started. After IVIG 4-day, the patient had recovery of her strength. To the authors’ knowledge, there are two case reports of pediatric individuals linking CSD and GBS/ATM. Still, this association in an adult patient has not been reported until the present moment.

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COVID-19 infection complicated by Guillain-Barre Syndrome: a systematic review of clinical features, pathogenic mechanism, and respiratory failure

Journal of Research in Clinical Medicine ◽

10.34172/jrcm.2021.034 ◽

2021 ◽

Vol 9 (1) ◽

pp. 34-34

Author(s):

Mahya Khaki ◽

Parastoo Dehghan ◽

Naghmeh Malekzadeh ◽

Mohsen Khamoushi ◽

Fahimehalsadat Shojaei ◽

...

Keyword(s):

Systematic Review ◽

Respiratory Failure ◽

Clinical Features ◽

Case Reports ◽

Case Series ◽

Diagnostic Workup ◽

Guillain Barre Syndrome ◽

World Health ◽

Guillain Barré Syndrome ◽

Guillain Barré

Background: The World Health Organization (WHO) declared a pandemic in March 2020 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Given the neurotropism feature of the coronavirus and growing number of COVID-19 associated neurological disorders, including Guillain Barre syndrome (GBS), we conducted a systematic review to thoroughly describe the clinical features, diagnostic workup, and clinical outcome of COVID-19 associated GBS in 78 cases. Methods: We identified case reports and case series of COVID-19 associated GBS by conducting a search in the PubMed/MEDLINE and EMBASE databases. We assessed the quality of studies using an appraisal checklist presented by Cochrane Murad et al. Extracted data included demographic characteristics, clinical presentation, diagnostic workup, and outcome. Results: The systematic search yielded a total of 60 articles reporting 78 patients with a diagnosis of COVID-19 associated GBS. The patients were mainly male (65.3%) with an average age of 57 years. The ascending symmetrical paresis was the most common presentation (79.4%), with demyelinating pattern in 54 patients (79.4%). The CSF analysis showed albuminocytologic dissociation in 48 patients (75%). The mortality of COVID-19 associated GBS was estimated as 6.4% attributable to progressive respiratory failure. Conclusion: Given the associated morbidities such as respiratory failure in patients with COVID-19 associated GBS, its timely detection is crucial to prevent poor clinical outcomes. On the other hand, clinicians must be vigilant to identify the clinical findings of SARS-CoV-2 infection in newly diagnosed GBS patients, as this might be a neurological complication of the subclinical viral infection.

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