GUILLAIN-BARRÉ SYNDROME AFTER CHIKUNGUNYA VIRUS INFECTION

2018 ◽  
Vol 23 (45) ◽  
pp. 173-178
Author(s):  
Marco Orsini ◽  
Denise Flávio De Carvalho ◽  
José Teixeira De Seixas Filho ◽  
Rossano Fiorelli ◽  
Eduardo Lima Trajano
Keyword(s):  
Specific Treatment ◽  
Control Measures ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Effective Prevention ◽  
Cranial Nerve Palsies ◽  
Guillain Barré Syndrome ◽  
Prevention And Control Measures ◽  
Guillain Barré ◽  
And Control

Background: In Brazilian territory, the most common arboviruses are DENV (Dengue), CHIKV (Chikungunya), and ZIKV (Zica), although others may spread in the country. These arboviruses has also resulted in a number of neurologic diseases such as Guillain-Barré syndrome, meningoencephalitis, myositis and cranial nerve palsies. This article reports the case of a woman, 33 years that suddenly developed shooting fever, muscle pain and ascedent weakness, receiving subsequently the diagnosis of guillain-barré syndrome for probable unspecified viral infection. After a few days of hospitalization, the diagnosis of Guillain-Barre by possible CHIKV fever were confirmed across clinical evaluation, cerebrospinal fluid, electrophysiological findings and the specific titles of IgM for CHIKV. Months after treatment with intravenous immunoglobulin remains with muscle weakness in lower limbs and difficulties in performing daily activities. The article becomes important because chikungunya infection causes a high number of affected individuals, with severe cases (as presented), and implications for health services, mainly due to the absence of specific treatment, vaccines, and effective prevention and control measures.

scholarly journals Paraparetic Variant of Guillain-Barré Syndrome in First 24 Hours of Postpartum Period: A case report

2020 ◽  
Vol 20 (2) ◽  
pp. 227
Author(s):  
Danah Aljaafari ◽  
Noman Ishaque
Keyword(s):  
Saudi Arabia ◽  
Case Report ◽  
Postpartum Period ◽  
Cranial Nerves ◽  
Specific Treatment ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Body Regions ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Guillain-Barré syndrome (GBS) is a heterogeneous disorder with a diverse clinical presentation ranging from weakness of certain body regions to tetraparesis with autonomic dysfunction and respiratory failure. Paraparetic GBS is a variant of GBS which is characterised by weakness limited to the lower limbs only. It is crucial to identify such topographical presentations, as a delay in diagnosis can lead to delayed initiation of specific treatment, which can negatively impact the outcome. We report a 29-year-old female patient who presented to the King Fahd Hospital of the University, Al Khobar, Saudi Arabia, in 2017 with rapid onset asymmetrical weakness of lower extremities associated with bladder dysfunction during the immediate postpartum period. The weakness spared cranial nerves and arms and imaging studies of the spine was unremarkable. Cerebrospinal fluid investigations showed cyto-albuminologic dissociation and nerve conduction studies showed features of demyelination. The patient was diagnosed with a paraparetic variant of GBS and treated with intravenous immunoglobulin. She had almost recovered completely at the two–month follow-up.Keywords: Paraparesis; Guillain-Barré Syndrome; Demyelination; Postpartum Period; Case Report; Saudi Arabia.

scholarly journals Acute inflammatory polyradiculoneuropathy of atypical presentation.

2021 ◽  
Author(s):  
Yasmim Nadime José Frigo ◽  
Hendrick Henrique Fernandes Gramasco ◽  
Ana Flavia Andrade ◽  
Guilherme Drumond Jardini Anastácio ◽  
Stella de Angelis Trivellato ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Peripheral Facial Paralysis ◽  
Early Improvement ◽  
Guillain Barré Syndrome ◽  
Symptom Variability ◽  
Guillain Barré ◽  
Trigeminal Nerves ◽  
Peripheral Sensory

Introduction: Guillain-Barré syndrome is an acute / subacute inflammatory polyradiculoneuropathy that classically results in flaccid areflex palsy. However, there are other possibilities of clinical presentation that must be remembered so that an adequate diagnosis and treatment is carried out. Case report: Female patient, 23 years old, without comorbidities, with complaint of paresthesia in extremities and right peripheral facial paralysis, having diagnosis until then of Bell’s Palsy. She denied previous or current infectious complaints. The neurological examination revealed facial diparesis, proximal weakness of the lower limbs that made walking difficult, tactile and painful hypoesthesia in the feet, with reflexes 1+/4+ in the lower limbs and 3+/4+ in the upper limbs. An investigation was started with CSF collection that showed albuminocytological dissociation (proteins 440 mg/dl and leukocytes 01 mm3). Neuroimaging exams showed contrast impregnation in facial and trigeminal nerves. A diagnosis of acute inflammatory polyradiculoneuropathy was made and treatment with human immunoglobulin was initiated for 5 days. Electroneuromyography showed peripheral, sensory-motor polyradiculoneuropathy and questioned the physiopathological possibility of juxtaparanodopathy. The patient presented a significant and early improvement after treatment. Conclusions: It is essential to consider that Guillain-Barré syndrome has symptom variability, especially according to its pathophysiology and clinical and electrophysiological variant, thus avoiding that conditions such as this one are underdiagnosed.

Case Report on Guillain Barre Syndrome: Acute Inflammatory Demyelinating Polyneuropathy

2021 ◽  
Vol 8 (9) ◽  
pp. 548-550
Author(s):  
Chinnu Roy ◽  
Jobin Kunjumon Vilapurathu ◽  
Dhanya Paul
Keyword(s):  
Case Report ◽  
Medical Condition ◽  
Demyelinating Polyneuropathy ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Limb Weakness ◽  
Acute Inflammatory Demyelinating Polyneuropathy ◽  
Guillain Barré Syndrome ◽  
Inflammatory Demyelinating Polyneuropathy ◽  
Guillain Barré

Guillain Barre Syndrome (GBS) is an autoimmune disorder which affects the peripheral nervous system. It is a rare disorder affects in 1 per million people in year. It is characterized by symmetrical, progressive limb weakness and tingling. Case Report: A 53 year old male patient was presented with insidious onset of difficulty in moving right upper and lower limbs as well as gradual weakness of left limbs, and breathing difficulty, known case of diabetics’ mellitus and hypertension. Nerve conduction study shows suggest axonopathy; Acute Inflammatory Demyelinating Polyneuropathy (AIDP) is identified, which is a subtype of Guillain Barre Syndrome. Patient gradually develops areflexia, bifacial weakness, and quadriparesis. Patient was treated with IV immunoglobulin and intranasal oxygen therapy. Patient shows slight improvement in his medical condition, shows improvement in the power of lower limbs after one week of therapy. Physiotherapy was suggested. Keywords: Guillain Barre Syndrome, GBS, Acute Inflammatory Demyelinating Polyneuropathy, AIDP.

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 Assessing healthcare workers’ knowledge, emotions and perceived institutional preparedness about COVID-19 pandemic at Saudi hospitals in the early phase of the pandemic

2020 ◽  
Vol 9 (4) ◽  
Author(s):  
Nashi Masnad Alreshidi ◽  
Hassan Haridi ◽  
Rana Alaseeri ◽  
Michelle Garcia ◽  
Fe Gaspar ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Knowledge Score ◽  
Control Measures ◽  
Emotional Impact ◽  
Cross Sectional ◽  
Web Based ◽  
Effective Prevention ◽  
Impact Scale ◽  
Prevention And Control Measures ◽  
And Control

Background: Coronavirus disease 2019 (COVID-19) pandemic extended to reach most countries in the globe during few months. Preparedness of healthcare institutions and healthcare workers (HCWs) are crucial for applying effective prevention and control measures. This study aimed to assess HCWs knowledge, emotions and perception of preparedness of their institutions towards COVID-19 pandemic.Design: A cross-sectional, web-based survey was conducted among hospital HCWs in Saudi Arabia during April 27, 2020 to May 03, 2020.Results: Overall, 1004 completed responses were received. The majority were females (78.8), nurses (84.9%) at middle age 25-39 years (71.8%). Among participants, 95.5% reported receiving training on safely use of personal protective equipment (PPE) and 94.9% did fit the test for N95 respirator. The participants possessed a fair knowledge about COVID-19 disease with a mean knowledge score 6. 61±1.35 points on a scale of 10 points. Most participants (88.7%) were committed to continue work as a professional and ethical duty, however, 27.1% of them scored high on a negative emotional impact scale. Participants appreciated most aspects of institutional preparedness for COVID-19 pandemic; however, they were concerned with the continuous PPE supply. Factors that independently associated with good knowledge and negative emotional response were determined using multivariate logistic regression analysis.Conclusions: Findings revealed fair knowledge about COVID-19 pandemic among HCWs in Saudi hospitals. Concerns and worries were expressed regard working with the highly infectious COVID-19 patients. Participants, appreciated most aspects of institutional preparedness, however they were concerned about the continuous availability and supply of PPE.

scholarly journals The use of standardized order sets to optimize treatment for Guillain-Barre Syndrome: a literature review

2015 ◽  
Vol 42 (S1) ◽  
pp. S35-S35
Author(s):  
V Karnik ◽  
T Roberts ◽  
W Johnston
Keyword(s):  
Treatment Options ◽  
Specific Treatment ◽  
Guillain Barre Syndrome ◽  
Published Data ◽  
Disease States ◽  
Order Sets ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Disease Specific ◽  
Order Set

Background: Standardized order sets are thought to improve patient outcomes in multiple ways. They reduce costs without reducing quality of care, and improve efficiency. In both surgical and medical conditions patients benefit from order sets in various disease states. In Guillain-Barre syndrome (GBS), the use of standardized order sets may be beneficial as there are a defined set of disease-specific diagnostic tests and treatments to be implemented. Here, the primary aim was to search for, and evaluate standardized order sets for GBS, and to provide a basis for development of future pathways. Methods: We used the Cochrane, TRIP, and MEDLINE/PUBMED databases, searching between January 1966 and April 2014. Search terms included: “Guillain-Barre Syndrome” and its synonyms, “(standardized) order set”, “clinical pathway”, “neurology” and “admission bundle.” Results: Despite anecdotal evidence of order sets, no formal data has been published showing benefit after implementation of these sets in GBS or any neurological condition. Conclusions: Although evidence exists for use of standardized order sets in surgical and medical settings, no published data exist in neurology. Given GBS has a defined set of disease-specific and state-specific treatment options, a standardized order set used on admission for GBS patients may prove to be beneficial.

scholarly journals Post-treatment Guillain-Barre Syndrome in a Patient with Brucellosis; A Case Report

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Navid Manouchheri ◽  
Omid Mirmosayyeb ◽  
Majid Ghasemi ◽  
Shervin Badihian ◽  
Vahid Shaygannejad ◽  
...  
Keyword(s):  
Case Report ◽  
Antimicrobial Treatment ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Case Presentation ◽  
Brucella Infection ◽  
Guillain Barré Syndrome ◽  
History Of ◽  
Guillain Barré ◽  
Uncommon Complication

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.

scholarly journals Fulminant Guillain Barre syndrome with recurrent lung collapse

2020 ◽  
Vol 10 (1) ◽  
pp. 127
Author(s):  
Hasif Kolleri ◽  
Mohammed Fardan ◽  
A. Priya ◽  
K. Arun Chander
Keyword(s):  
Muscle Power ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Mechanically Ventilated ◽  
Guillain Barré Syndrome ◽  
Brainstem Function ◽  
Upper Respiratory ◽  
Guillain Barré ◽  
Minimal Resistance ◽  
Nasal Regurgitation

Fulminant Guillain-Barré syndrome (GBS) is a rapidly progressive form of polyneuropathy in which patients demonstrate eventual flaccid quadriplegia and an absence of brainstem function. Most patients present initially with a mild upper respiratory or gastrointestinal illness and have non-diagnostic cerebral imaging studies. Here we report the case of child aged 7 who was admitted initially with complaints of weakness of lower limbs lasting for 4-5 hours. He had difficulty in standing and walking, associated with pain in both lower limbs. Flaccid weakness rapidly progressed over 12 hours to involve both upper limbs along with difficulty in swallowing and nasal regurgitation of feeds. He was intubated and mechanically ventilated for respiratory failure. Over the period of time, after confirmation with all the test reports and symptoms, other differential diagnoses were ruled out and fulminant GBS was considered and hence plasmapheresis was started. Over the period of 3 months his muscle power slowly improved. During discharge, he was able to lift limbs against minimal resistance, turn sideways on bed, sit up with minimal support and likewise stand with support.

scholarly journals The importance of early neurorehabilitation in the recovery of post-vaccination Guillain-Barre syndrome – a case report

2019 ◽  
Vol 10 (10.2) ◽  
pp. 98-102 ◽  
Author(s):  
Mihai Sava ◽  
Maria-Gabriela Catană ◽  
Corina Roman-Filip
Keyword(s):  
Influenza Vaccine ◽  
Final Diagnosis ◽  
Acute Onset ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Presumptive Diagnosis ◽  
Guillain Barré Syndrome ◽  
One Year ◽  
Double Filtration ◽  
Guillain Barré

Abstract Guillain-Barre syndrome (GBS) is the most common cause of acute flaccid paralysis worldwide, having an incidence of about 1/100,000 across several studies in a number of countries. We present the case of a 60-year-old female patient, with known hypertension, admitted to our department for paresthesia and muscle weakness predominantly in the distal upper and lower limbs. Symptomatology had an acute onset after 14 days from influenza vaccine administration. Lumbar puncture revealed CSF glucose (91 mg/dl), CSF protein (0.508 g/l) and no pleocytosis. Electromyography supported the presumptive diagnosis of polyradiculoneuritis. The patient underwent three sessions of double filtration and the final diagnosis was Guillain-Barre polyradiculoneuritis secondary to influenza vaccination. Approximately 80% of patients with polyradiculoneuritis recover completely within a few months to one year; however, 5-10% of these patients experience one or more recurrences. It should be emphasized that acute-phase rehabilitation must start immediately and include an individualized program of gentle strengthening, and manual resistive and progressive resistive exercises. Key words: polyradiculoneuropathy, influenza vaccine, neurorehabilitation,

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