scholarly journals Epidemiologic features of Guillain-Barré syndrome in São Paulo, Brazil

2004 ◽  
Vol 62 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Maria Sheila Guimarães Rocha ◽  
Sônia Maria Dozzi Brucki ◽  
Alzira Alves de Siqueira Carvalho ◽  
Úrsula Waleska Poti Lima
Keyword(s):  
Seasonal Pattern ◽  
Age At Onset ◽  
Bimodal Distribution ◽  
Tertiary Hospital ◽  
Epidemiological Studies ◽  
Sao Paulo ◽  
Guillain Barre Syndrome ◽  
São Paulo ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

INTRODUCTION: There are few epidemiologic studies concerning Guillain-Barré syndrome (GBS). Due to difficulties with definition and lack of a standard diagnostic test of reference, GBS is not easy to study epidemiologically. We evaluate some epidemiological features of GBS in a sample of cases treated at a tertiary hospital in São Paulo, Brazil. METHOD: We retrospectively reviewed all cases of GBS with hospitalization in Santa Marcelina hospital, over the period of January 1995 through December 2002. RESULTS: Ninety-five cases were included in this study. Fifty-five were men and forty women, with a proportion of 1.4 men to 1 woman. The age ranged from 1 to 83 years with a mean age at onset of 34 years. GBS was less frequently observed below 15 years (18.9%) and above 60 years (16.9%). The highest frequency was observed in patients aged 15 to 60 years old (66.2%). The annual incidence rate was 0.6 cases/100,000 people. There was a highest frequency of cases during the months of September through March (62.1%). CONCLUSION: Our data differs from that of other epidemiological studies in that we did not observe a bimodal distribution in age and found a seasonal pattern in hotter months.

scholarly journals A CASE REPORT ON GUILLAIN BARRE SYNDROME (G B SYNDROME) IN CHILD – AN SUCCESSFUL APPROACH IN AYURVEDA

2020 ◽  
Vol 8 (9) ◽  
pp. 4556-4559
Author(s):  
Shruti K Kamath ◽  
Vinay Kumar K N
Keyword(s):  
Case Report ◽  
Autoimmune Disorder ◽  
The Elderly ◽  
Bimodal Distribution ◽  
Epidemiological Studies ◽  
Guillain Barre Syndrome ◽  
Common Symptom ◽  
Guillain Barré Syndrome ◽  
Successful Approach ◽  
Guillain Barré

Guillain Barre Syndrome is an autoimmune disorder encompassing a heterogeneous group of pathological and clinical entities. Antecedent infections are thought to trigger an immune response which subsequently cross reacts with nerves leading to demyelination or axonal degeneration. The condition can occur at any age. One of the earliest descriptions of what we know today as guillian barre syndrome is found in Land-ry’s report on 10 Patients with “ascending paralysis” in 1859. The annual incidence of G B Syndrome is around 1-3/100000 population according to epidemiological studies from Europe, USA and Australia. The age specific curve seems to show a bimodal distribution with peaks in young adults and the elderly. The risk of G B Syndrome is lower during pregnancy and increases after delivery. However, it can occur to children as well which is the common cause of acute flaccid paralysis (AFP) wherein the clinical features are acute paralysis evolving over days or weeks with loss of tendon reflexes. Pain is the most common symptom experienced by the patients. Here is a case report on a child aged 2 and half years suffering from G B syndrome who underwent Panchakarma treatment in Ayurveda under 2 phases that include Sarvanga Abhyanga, Sarvanga Shastika Shali Pinda Sweda, Dhanyamla Dhara, Agnilepa, Rajayapana Basti along with Physiotherapy and there were significant results observed.

Two success stories in the management of Guillain–Barré syndrome illustrate the challenges of intensive care unit care in Malawi

2020 ◽  
pp. 004947552096275
Author(s):  
Lauren Onofrey ◽  
Claire Naus ◽  
Kiran T Thakur ◽  
Clement Kadyaudzu ◽  
Meghan Prin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Early Recognition ◽  
Tertiary Hospital ◽  
Guillain Barre Syndrome ◽  
Intensive Care Unit Care ◽  
Low Resource ◽  
Success Stories ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

The management of critical illness is especially challenging in low-resource environments, and early recognition and supportive care are essential, regardless of the ability to employ advanced or invasive therapy. In this report, we discuss two patients with Guillain–Barré syndrome who were managed successfully in the intensive care unit of a tertiary hospital in Malawi. Both patients recovered and were discharged home. The management and outcomes of these patients provide case-based lessons for improving intensive care unit medicine in low-resource contexts.

scholarly journals The role of molecular mimicry in the etiology of Guillain Barré Syndrome

2011 ◽  
Vol 56 ◽  
pp. 3-12
Author(s):  
Aleksandra Grozdanova ◽  
Slobodan Apostolski ◽  
Ljubica Suturkova
Keyword(s):  
Molecular Mimicry ◽  
Epidemiological Studies ◽  
Guillain Barre Syndrome ◽  
Contributory Factor ◽  
Animal Disease Models ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Bacterial Lipopolysaccharides ◽  
Guillain Barré

Molecular mimicry between host tissue structures and microbial components has been proposed as the pathogenic mechanism for triggering of autoimmune diseases by preceding infection. Recent studies stated that molecular mimicry as the causative mechanism remains unproven for most of the human diseases. Still, in the case of the peripheral neuropathy Guillain-Barré syndrome (GBS) this hypothesis is supported by abundant experimental evidence. GBS is the most frequent cause of acute neuromuscular paralysis and in some cases occurs after infection with Campylobacter jejuni (C. jejuni). Epidemiological studies, showed that more than one third of GBS patients had antecedent C. jejuni infection and that only specific C. jejuni serotypes are associated with development of GBS. The molecular mimicry between the human gangliosides and the core oligosaccharides of bacterial lipopolysaccharides (LPSs) presumably results in production of antiganglioside cross-reactive antibodies which are likely to be a contributory factor in the induction and pathogenesis of GBS. Antiganglioside antibodies were found in the sera from patients with GBS and by sensitization of rabbits with gangliosides and C. jejuni LPSs animal disease models of GBS were established. GBS as prototype of post-infection immune-mediated disease probably will provide the first verification that an autoimmune disease can be triggered by molecular mimicry.

scholarly journals Is an Increased Risk of Developing Guillain–Barré Syndrome Associated with Seasonal Influenza Vaccination? A Systematic Review and Meta-Analysis

Vaccines ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 150 ◽  
Author(s):  
Marek Petráš ◽  
Ivana Králová Lesná ◽  
Jana Dáňová ◽  
Alexander M. Čelko
Keyword(s):  
Systematic Review ◽  
Influenza Vaccination ◽  
Influenza A ◽  
Seasonal Influenza ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Guillain Barre Syndrome ◽  
Increased Risk ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

While the weight of epidemiological evidence does not support a causal link with influenza vaccination evaluated over the last 30 years, Guillain–Barré syndrome (GBS) has been considered a vaccine-associated adverse event of interest since 1976. To investigate the existence of GBS risk after vaccination against seasonal influenza, a systematic review and meta-analysis have been conducted based on 22 eligible epidemiological studies from 1981 to 2019 reporting 26 effect sizes (ESs) in different influenza seasons. The primary result of our meta-analysis pointed to no risk of vaccine-associated GBS, as documented by a pooled ES of 1.15 (95% CI: 0.97–1.35). Conversely, an obvious high risk of GBS was observed in patients with previous influenza-like illness (ILI), as demonstrated by a pooled ES of 9.6 (95% CI: 4.0–23.0) resulting from a supplementary analysis. While the meta-analysis did not confirm the putative risk of vaccine-associated GBS suggested by many epidemiological studies, vaccination against seasonal influenza reduced the risk of developing ILI-associated GBS by about 88%. However, to obtain strong evidence, more epidemiological studies are warranted to establish a possible coincidence between vaccination and ILI prior to GBS onset.

scholarly journals Guillain-Barre syndrome in patients with coronavirus disease-2019: Report of six cases and review of literature

2021 ◽  
Author(s):  
Ali Asghar Okhovat ◽  
Behnaz Ansari ◽  
Helia Hemasian ◽  
Bahram Haghi-Ashtiani ◽  
Soroor Advani ◽  
...  
Keyword(s):  
Case Reports ◽  
Epidemiological Studies ◽  
Guillain Barre Syndrome ◽  
Response To Treatment ◽  
First Episode ◽  
Review Of Literature ◽  
Axonal Polyneuropathy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Progressive Weakness

Background: Few studies have reported the association of Guillain-Barre syndrome (GBS) and coronavirus disease-2019 (COVID-19) infection. In this study, we reported GBS in six patients infected with COVID-19 and reviewed all existing literature about GBS in association with COVID-19. Methods: This study was performed in three referral centers of COVID-19 in Iran, and six patients with the diagnosis of GBS were enrolled. Patients enrolled in the study with acute progressive weakness according to the demyelinating or axonal variant of GBS, according to Uncini's criteria. Results: Four of our patients had axonal polyneuropathy, two patients had demyelinating polyneuropathy, and one patient required mechanical ventilation. All our patients had a favorable response to treatment. In one patient, the GBS symptoms recurred four months after the first episode. Conclusion: Limited case reports suggest a possible association between GBS and COVID-19. Such associations may be an incidental concurrence or a real cause-and-effect linkage; however, more patients with epidemiological studies are necessary to support a causal relationship.

scholarly journals COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports

2020 ◽  
Vol 5 ◽  
pp. 107 ◽  
Author(s):  
Rodrigo M. Carrillo-Larco ◽  
Carlos Altez-Fernandez ◽  
Sabrina Ravaglia ◽  
Joaquín A. Vizcarra
Keyword(s):  
Systematic Review ◽  
Cerebrospinal Fluid ◽  
Case Reports ◽  
Epidemiological Studies ◽  
Preliminary Evidence ◽  
Guillain Barre Syndrome ◽  
Protein Levels ◽  
Guillain Barré Syndrome ◽  
Successful Resolution ◽  
Guillain Barré

Background: Guillain-Barre Syndrome (GBS) is a neurological autoimmune disease that can lead to respiratory failure and death. Whether COVID-19 patients are at high risk of GBS is unknown. Through a systematic review of case reports, we aimed to summarize the main features of patients with GBS and COVID-19. Methods: Without any restrictions, we searched MEDLINE, Embase, Global Health, Scopus, Web of Science and MedXriv (April 23 rd, 2020). Two reviewers screened and studied titles, abstracts and reports. We extracted information to characterize sociodemographic variables, clinical presentation, laboratory results, treatments and outcomes. Results: Eight reports (n=12 patients) of GBS and COVID-19 were identified; one was a Miller Fisher case. The age ranged between 23 and 77 years, and there were more men (9/102). GBS symptoms started between 5 and 24 days after those of COVID-19. The protein levels in cerebrospinal fluid samples ranged between 40 and 193 mg/dl. None of the cerebrospinal fluid samples tested positive for COVID-19. Six patients debuted with ascendant weakness and three with facial weakness. Five patients had favourable evolution, four remained with relevant symptoms or required critical care and one died; the Miller Fisher case had successful resolution. Conclusions: GBS is emerging as a disease that may appear in COVID-19 patients. Although limited, preliminary evidence appears to suggest that GBS occurs after COVID-19 onset. Practitioners and investigators should have GBS in mind as they look after COVID-19 patients and conduct research on novel aspects of COVID-19. Comparison with GBS patients in the context of another viral outbreak (Zika), revealed similarities and differences that deserves further scrutiny and epidemiological studies.

scholarly journals Guillain-Barré Syndrome Outbreak in Peru 2019 Associated With Campylobacter jejuni Infection

2021 ◽  
Vol 8 (2) ◽  
pp. e952
Author(s):  
Ana P. Ramos ◽  
Sonja E. Leonhard ◽  
Susan K. Halstead ◽  
Mireya A. Cuba ◽  
Carlos C. Castañeda ◽  
...  
Keyword(s):  
Campylobacter Jejuni ◽  
Genomic Analysis ◽  
Tertiary Hospital ◽  
Guillain Barre Syndrome ◽  
Upper Respiratory Tract ◽  
Microbiological Methods ◽  
Guillain Barré Syndrome ◽  
Arbovirus Infection ◽  
Guillain Barré ◽  
Pure Motor

ObjectiveTo identify the clinical phenotypes and infectious triggers in the 2019 Peruvian Guillain-Barré syndrome (GBS) outbreak.MethodsWe prospectively collected clinical and neurophysiologic data of patients with GBS admitted to a tertiary hospital in Lima, Peru, between May and August 2019. Molecular, immunologic, and microbiological methods were used to identify causative infectious agents. Sera from 41 controls were compared with cases for antibodies to Campylobacter jejuni and gangliosides. Genomic analysis was performed on 4 C jejuni isolates.ResultsThe 49 included patients had a median age of 44 years (interquartile range [IQR] 30–54 years), and 28 (57%) were male. Thirty-two (65%) had symptoms of a preceding infection: 24 (49%) diarrhea and 13 (27%) upper respiratory tract infection. The median time between infectious to neurologic symptoms was 3 days (IQR 2–9 days). Eighty percent had a pure motor form of GBS, 21 (43%) had the axonal electrophysiologic subtype, and 18% the demyelinating subtype. Evidence of recent C jejuni infection was found in 28/43 (65%). No evidence of recent arbovirus infection was found. Twenty-three cases vs 11 controls (OR 3.3, confidence interval [CI] 95% 1.2–9.2, p < 0.01) had IgM and/or IgA antibodies against C jejuni. Anti-GM1:phosphatidylserine and/or anti-GT1a:GM1 heteromeric complex antibodies were strongly positive in cases (92.9% sensitivity and 68.3% specificity). Genomic analysis showed that the C jejuni strains were closely related and had the Asn51 polymorphism at cstII gene.ConclusionsOur study indicates that the 2019 Peruvian GBS outbreak was associated with C jejuni infection and that the C jejuni strains linked to GBS circulate widely in different parts of the world.

scholarly journals COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports

2020 ◽  
Vol 5 ◽  
pp. 107 ◽  
Author(s):  
Rodrigo M. Carrillo-Larco ◽  
Carlos Altez-Fernandez ◽  
Sabrina Ravaglia ◽  
Joaquín A. Vizcarra
Keyword(s):  
Systematic Review ◽  
Cerebrospinal Fluid ◽  
Case Reports ◽  
Epidemiological Studies ◽  
Preliminary Evidence ◽  
Guillain Barre Syndrome ◽  
Protein Levels ◽  
Guillain Barré Syndrome ◽  
Successful Resolution ◽  
Guillain Barré

Background: Guillain-Barre Syndrome (GBS) is a neurological autoimmune disease that can lead to respiratory failure and death. Whether COVID-19 patients are at high risk of GBS is unknown. Through a systematic review of case reports, we aimed to summarize the main features of patients with GBS and COVID-19. Methods: Without any restrictions, we searched MEDLINE, Embase, Global Health, Scopus, Web of Science and MedXriv (April 23rd, 2020). Two reviewers screened and studied titles, abstracts and reports. We extracted information to characterize sociodemographic variables, clinical presentation, laboratory results, treatments and outcomes. Results: Eight reports (n=12 patients) of GBS and COVID-19 were identified; one was a Miller Fisher case. Overall, the median age was 62.5 (interquartile range (IQR)=54.5-70.5) years, and there were more men (9/102). GBS symptoms started between 5 and 24 days after those of COVID-19. The median protein levels in cerebrospinal fluid samples was 101.5 mg/dl (IQR=51-145). None of the cerebrospinal fluid samples tested positive for COVID-19. Six patients debuted with ascendant weakness and three with facial weakness. Five patients had favourable evolution, four remained with relevant symptoms or required critical care and one died; the Miller Fisher case had successful resolution. Conclusions: GBS is emerging as a disease that may appear in COVID-19 patients. Although limited, preliminary evidence appears to suggest that GBS occurs after COVID-19 onset. Practitioners and investigators should have GBS in mind as they look after COVID-19 patients and conduct research on novel aspects of COVID-19. Comparison with GBS patients in the context of another viral outbreak (Zika), revealed similarities and differences that deserves further scrutiny and epidemiological studies.

scholarly journals Epidemiological and clinical aspects of Guillain-Barré syndrome and its variants

2021 ◽  
Vol 79 (6) ◽  
pp. 497-503
Author(s):  
Dayanne Rodrigues da Cunha Alves Bento Oliveira ◽  
Rubens Nelson Morato Fernandez ◽  
Talyta Cortez Grippe ◽  
Fabiano Silva Baião ◽  
Rafael Lourenco Duarte ◽  
...  
Keyword(s):  
Rainy Season ◽  
Axonal Neuropathy ◽  
Age At Onset ◽  
Guillain Barre Syndrome ◽  
Clinical Aspects ◽  
Acute Motor Axonal Neuropathy ◽  
Cross Sectional ◽  
Guillain Barré Syndrome ◽  
The Mean ◽  
Guillain Barré

Abstract Background: Guillain-Barré syndrome (GBS), an acute polyradiculoneuropathy that occurs because of an abnormal inflammatory response in the peripheral nervous system, is clinically characterized by acute flaccid paresis and areflexia with or without sensory symptoms. This syndrome can lead to disabling or even life-threatening sequelae. Objective: This study aimed to present the clinical and epidemiological aspects of GBS in patients admitted to a tertiary-level hospital in the Federal District between January 2013 and June 2019. Methods: In this observational, cross-sectional and retrospective study, medical records of patients diagnosed with acute inflammatory demyelinating polyradiculoneuropathy, acute motor axonal neuropathy or acute axonal motor-sensitive neuropathy based on electromyographic findings were included, and clinical data were collected retrospectively. Results: A total of 100 patients (63 males and 37 females; ratio, 1.7:1) aged 2–86 years (mean, 36.4 years) were included. The mean annual incidence rate of GBS was 0.54 cases/100,000 inhabitants, with 52 and 49% of the cases occurring between October and March (rainy season) and between April and September (dry season), respectively. The proportions of patients showing each GBS variant were as follows: demyelinating forms, 57%; axonal forms, 39%; and undetermined, 4%. The mean duration of hospitalization was 8–15 days for most patients (38%). During hospitalization, 14% of the patients required mechanical ventilation and 20% experienced infectious complications. Conclusion: The findings indicate that there was an increase in the incidence of GBS during the rainy season. Moreover, we did not observe the typical bimodal distribution regarding age at onset.

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