scholarly journals Craniofacial and neurological manifestations in patients with Guillain-Barré Syndrome.

2021 ◽  
Vol 10 (2) ◽  
pp. 1-9
Author(s):  
Rubén Chumpitaz-Durand ◽  
◽  
Freddy Manayay ◽  
Keyword(s):  
Oral Hygiene ◽  
Cranial Nerves ◽  
Cross Sectional Study ◽  
Guillain Barre Syndrome ◽  
Neurological Manifestations ◽  
Cross Sectional ◽  
Stomatognathic System ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Functional Alteration

Introducción: Among the broad range of symptoms of the Guillain-Barré Syndrome (GBS), patients can present craniofacial manifestations. Consequently, the participation of the dental surgeon in the evaluation of the stomatognathic system using a multidisciplinary approach model is very important. Objective: To identify the craniofacial and neurological manifestations of the Guillain-Barré Syndrome in patients from three hospitals in the district of Lambayeque, Peru, in 2019. Material and Methods: A descriptive, prospective, and cross-sectional study was carried out in 59 patients diagnosed with GBS by means of a clinical evaluation carried out by previously calibrated neurologists (k=0.911). Additionally, an oral evaluation of the oral hygiene index, the periodontal status, and the oral pH was carried out. Data were processed using frequency distribution tables. Results: 44.07% of the patients presented at least one functional alteration, such as unilateral limitation for facial expressions (25.42%), dysphagia (18.64%), alteration in phonation (11.86%), and loss of the sense of taste (6.78%), showing involvement of the corresponding cranial nerves. In addition, unfavorable conditions oforal hygiene and acid pH were observed in some cases, which proved adverse for the periodontal structures of the patients. Conclusion: The study found craniofacial manifestations of GBS, such as cases of unilateral facial palsy, dysphagia, difficulty in phonation, and loss of the sense of taste, due to the alteration of the cranial nerves that command these functions. In addition, poor oral hygiene, and the presence of acidic pH in some patients created an adverse environment for the integrity of the periodontal structures.

scholarly journals Clinical and ElectrophysiologicAspects of Guillain Barre Syndrome among Children: Experience at Referral Tertiary Care Hospital in Bangladesh

2019 ◽  
Vol 5 (1) ◽  
pp. 2-7
Author(s):  
Bithi Debnath ◽  
Mohammad Enayet Hussain ◽  
Nazmul Haque ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Income Group ◽  
Cross Sectional Study ◽  
Guillain Barre Syndrome ◽  
Care Hospital ◽  
Cross Sectional ◽  
Middle Income ◽  
Guillain Barré Syndrome ◽  
Middle Income Group ◽  
Guillain Barré

Background: Guillain Barre Syndrome (GBS) is an acute polyradiculopathy which is quite common in all ages. Objective: The aim of this study was to evaluate the clinical and electrophysiologicaspects of Guillain Barre Syndrome (GBS) in children. Methodology: This cross-sectional study was carried out in the Department of Neurophysiology of National Institute of Neurosciences and Hospital, Bangladesh from July 2016 to June 2018. Patients under 18 years of age fulfilling Brighton diagnostic criteria for GBS were included in this study. These patients were evaluated by detailed history, physical examination, and electrophysiological findings. Results: A total of 82 patients of GBS were enrolled in this study. The mean age was 12.93± 5.02 years (range 1 to<18 years). Most of the patients were male (64.6%) and from the middle-income group (70.73%). About Fourty eight percent of patients had a history of preceding illness among which gastrointestinal infection(24.3%) was the most common. Tingling and paresthesiaswas complained by 32.4% of patients as the first symptom. AMAN(61%) was the most common GBS variant followed by AIDP(26.8%). 9 (11%) patients needed ICU support among them AIDP was more frequent. Conclusion: AMAN is the most common variant among children in this population by electrophysiologic testing. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 2-7

scholarly journals Guillain barre syndrome and its association with covid-19 infection – A clinical case series

2022 ◽  
Vol 7 (4) ◽  
pp. 326-333
Author(s):  
Madhavi Karri ◽  
Deepak Jacob ◽  
Balakrishnan Ramasamy ◽  
Santhosh Perumal
Keyword(s):  
Intravenous Immunoglobulin ◽  
Nerve Conduction ◽  
Cranial Nerves ◽  
Case Series ◽  
Nerve Conduction Studies ◽  
Guillain Barre Syndrome ◽  
Nasopharyngeal Swab ◽  
Neurological Manifestations ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

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.

Relationship of Glycemic Status with Disease Severity in Guillain-Barré Syndrome

2020 ◽  
Vol 6 (2) ◽  
pp. 96-100
Author(s):  
Mohammad Akter Hossain ◽  
Mashfiqul Hasan ◽  
Mohammad Atiqur Rahman ◽  
Murshed Baqui ◽  
Mahmudul Islam ◽  
...  
Keyword(s):  
Disease Severity ◽  
Cross Sectional Study ◽  
Assisted Ventilation ◽  
Guillain Barre Syndrome ◽  
Disability Score ◽  
Cross Sectional ◽  
Sum Score ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Relationship Of

Background: Guillain-Barré syndrome (GBS) is an acute autoimmune polyneuroradiculopathy characterized by flaccid paralysis which may lead to respiratory failure requiring intensive care. Objective: The purpose of the present study was to explore the relationship between the fasting plasma glucose (FPG), hemoglobin A1c (HbA1c) and disease severity of GBS patients who are not known to have DM. Methodology: This cross-sectional study included adult GBS patients without having DM [age 35 (22-48) years, median (interqurtile range, IQR); 39 male 22 female] who were admitted to Neurology department, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from July 2018 to June 2019. Demographics, clinical data were noted and FPG, HbA1c were measured. Disease severity were assessed by the GBS disability scale ranging from 0 to 6 with increasing score reflecting increased disability. Results: Patients with more severe GBS (disability score ≥4, unable to walk) had higher frequency of elevated FPG >5.5 mmol/L (61.2%; 30/49) in comparison to those with less severe GBS (disability score ≤3, able to walk; FPG >5.5 mmol/L in 16.7%, 2/12; p=0.006). But distribution of HbA1c category was not different across the groups (disability score ≥4 vs. ≤3: HbA1c <5.7: 40% vs. 58%; 5.7-6.4: 50% vs. 25%; >6.4: 10% vs. 17%; p=0.296). Participants with elevated FPG were elder [elevated vs. normal FPG: 40 (28-54) vs. 25 (19-43) years; median (IQR), p=0.012] and had higher CSF glucose (p=0.002) than those with normal FPG, but there was no difference in respct of gender, MRC sum score, requirement of assisted ventilation, CSF protein, GBS subtypes and duration of hospital stay (p=not significant for all). Conclusions: Patients with severe GBS have higher frequency of elevated FPG but not HbA1c. An acute change in glucose metabolism may occur in GBS which needs further study. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 96-100

scholarly journals Evaluation of demographic, clinical and paraclinical features of children with Guillain-Barré syndrome

2020 ◽  
Vol 5 (2) ◽  
pp. e23-e23
Author(s):  
Ahad Ghazavi ◽  
Ezatolah Abbasi ◽  
Sahar Mohammadi
Keyword(s):  
Respiratory Distress ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Guillain Barre Syndrome ◽  
Severe Respiratory Distress ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Guillain Barré Syndrome ◽  
Urban Rural ◽  
Guillain Barré

Introduction: Guillain-Barré syndrome (GBS) is an acute polyneuropathy accompanied by muscle weakness, myalgia, and bulbar involvement. Objectives: We evaluated demographic, clinical and paraclinical features of children with this disease. Patients and Methods: In this cross-sectional study, the data of 83 patients with GBS were studied. All data about age, gender, place of residence (urban, rural), season of infection, history of infection or vaccination in the last month, clinical demonstrations and spinal magnetic resonance imaging findings with contrast, electromyography (EMG), nerve conduction velocity (NCV), cerebrospinal fluid (CSF), C-reactive protein (CRP) analysis was analyzed. Results: In this study, the highest incidence of GBS was in the summer (30.12%). Regarding clinical symptoms, 54.21% of patients were unable to walk, and around14.45 % of cases had positive Gowers’ sign. Additionally, 27.71% of patients reported pain, since 7.22% of them had severe respiratory distress with the need for mechanical ventilation. In patients who underwent EMG-NCV, findings were in favor of GBS in most cases (89.83%). In lumbar puncture, 53% of patients had normal CSF. Most patients (75.9%) had an erythrocyte sedimentation rate (ESR) below 30 mm/h. CRP of most patients (83.33%) was less than 10 mg/L. Conclusion: The predominant clinical symptoms of patients with GBS are the inability to walk, imbalance, positive Gowers’ sign, pain and respiratory distress, since ESR and CRP less than 30 and 10 mg/L are helpful, respectively.

Sensory symptoms on admission as a predictor of respiratory insufficiency in patients of Guillain-Barre Syndrome (GBS)

2020 ◽  
pp. 1-9
Author(s):  
Ayesha Aslam ◽  
Iqra Anwar ◽  
Adnan Tariq
Keyword(s):  
Respiratory Distress ◽  
Respiratory Insufficiency ◽  
Blood Gases ◽  
Cross Sectional Study ◽  
Guillain Barre Syndrome ◽  
Cross Sectional ◽  
Single Breath ◽  
Arterial Blood ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Abstract Objective: To assess sensory symptoms on presentation as a predictor of respiratory insufficiency in patients of Guillain-Barre Syndrome. Methods: The descriptive cross-sectional study was conducted from November 2018 to March 2019 at the Neurology Department of King Edward Medical University, Lahore, Pakistan, and comprised patients aged 18-60 years suffering from Guillain-Barre Syndrome as per Brighton criteria. All patients were monitored for respiratory insufficiency by single breath count and arterial blood gases. Data was analysed using SPSS 22. Results: Of the 87 patients, 61(70.1%) were male and 26(29.9%) were female. The overall mean age was 37.51±15.36 years. Sensory symptoms were noted in 27(31%) patients, and respiratory distress in 17(19.5%). Of those who had sensory symptoms, 10(37%) also had sensory symptoms. Conclusion: Respiratory insufficiency in Guillain-Barre Syndrome patients presenting with sensory symptoms was common. Key Words: Guillain Barre syndrome, GBS), Respiratory distress, Sensory symptoms.

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 Electrophysiological patterns in patient with Guillain-Barre syndrome

2021 ◽  
Vol 12 (1) ◽  
pp. 16-21
Author(s):  
SM Monowar Hossain ◽  
Zahed Ali ◽  
Mohammad Motiur Rahman ◽  
Md Aolad Hossain ◽  
Pallab Kanti Saha ◽  
...  
Keyword(s):  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Axonal Neuropathy ◽  
Clinical Findings ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Cross Sectional ◽  
Female Ratio ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Background: Guillain-Barre syndrome (GBS) is an acute, frequently severe and fulminant polyradiculoneuropathy that is autoimmune in nature. Incidence and predominant subtypes of GBS differ geographically. Electrophysiology has important role in subtyping GBS. This study aimed to evaluate the electrophysiological findings in patient of GBS. Methods: This was a hospital based cross-sectional descriptive study and conducted at the Department of Neurology in Sir Salimullah Medical College & Mitford Hospital, Dhaka and National Institute of Neurosciences and Hospital, Dhaka during July 2017 to June 2018. Clinically diagnosed 53 patients with GBS were enrolled according to prefixed selection criteria. Detail history taking, clinical examination, nerve conduction study and cerebrospinal fluid (CSF) examination was performed in all cases. Clinical findings, nerve conduction study (NCS) parameters, CSF findings and demographic profiles were evaluated. Results: Mean ± SD age of presentation was 41.64 (±14.56) years and median age was 42.0 years. There were total 33(62 %) males and 20 (38 %) females with male: female ratio of 1.7:1. Clinically two-thirds(62.3%) of patients had both upper and lower limb involvement (62.3%), facial weakness was in 32.1% and 13.2% had bulbar involvement. Acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN)were found to be 51%, 32% and 17% respectively. CSFprotein was elevated in most of the patients with a range of 16-725 mg/dl. Highest CSF protein was found in AIDP. Conclusion: Electrophysiological studies play an important role in the early detection; characterization of GBS.In this study, the commonest type of GBS was AIDP. Higher levels of CSF protein, absent H-reflex and Fresponse, sural sparing and unexcitable nerves are more frequently present in AIDP. BIRDEM Med J 2022; 12(1): 16-21

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

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.

Guillain – Barré syndrome associated with SARS-CoV-2 infection

2021 ◽  
Author(s):  
E. I. Tsoma
Keyword(s):  
Cranial Nerves ◽  
Respiratory Muscles ◽  
Guillain Barre Syndrome ◽  
Haemophilus Influenzae Type ◽  
Barr Virus ◽  
Progressive Muscle Weakness ◽  
Fluid Analysis ◽  
Disturbance Of Consciousness ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Neurological manifestations of COVID‑19 infection are caused by its effects on CNS (headache, dizziness, disturbance of consciousness, convulsions, etc.) and PNS (anosmia, ageusia, visual impairment, radiculo‑ and neuropathy). Guillain – Barré syndrome (GBS) is a rare autoimmune disease associated with damage to the peripheral nervous system. 40 — 70 % of cases are associated with a previous infection: cytomegalovirus, Epstein–Barr virus, Haemophilus influenzae type b, Mycoplasma pneumoniae, Campylobacter jejuni etc. The clinical characteristics of this condition are progressive muscle weakness, reduction or loss of tendon reflexes (hyporeflexia and areflexia), paresthesias, paresis of the cranial nerves. The diagnosis is based on clinical data, cerebrospinal fluid analysis (protein level, cytosis, antigangliosid antibodies), as well as electroneuromyography. Most patients with Guillain – Barré syndrome totally recover. However, the most dangerous and severe complication of acute inflammatory demyelinating polyneuropathy is paralysis of the respiratory muscles. About a quarter of patients require urgent treatment at intensive care unit with mechanical ventilation and/or tracheostomy. Mortality in Guillain – Barré syndrome can reach to 10 %. There have been several reports of COVID‑19‑related GBS in the world scientific medical literature during the last year, but more information about this association and its implications is still missing. The aim of this report was to analyze the available information about cases of Guillain – Barré syndrome associated with COVID‑19 infection, to compare different variants of this condition and to share our own experience in clinical management of such patient.

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