scholarly journals Acute Guillain Barre Syndrome in A Hemodialysis Patient with Diabetic Nephropathy: A Case Report

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Zhi Xiao

Acute Guillain Barre syndrome is a common type of autoimmune mediated acute peripheral neuropathy. Its initial symptoms are symmetrical limb weakness, sensory disturbance, pain or other symptoms. This paper reports a case of acute Guillain Barre syndrome in a uremic patient with diabetic nephropathy and long-term regular hemodialysis, in order to further explore the clinical manifestations and differential characteristics of uremic patients with acute Guillain Barre syndrome, improve the early diagnosis rate of uremic patients with acute Guillain Barre syndrome, make the patients get timely treatment, so as to reduce the disability of such patients To improve the prognosis of the disease.

2021 ◽  
Vol 12 ◽  
Author(s):  
Jing Sun ◽  
Yu Gao ◽  
Lumei Chi ◽  
Qingyang Cao ◽  
Zhijie Ning ◽  
...  

Introduction: Guillain–Barre syndrome (GBS) is an acute immune-mediated inflammatory demyelinating polyneuropathy characterized by symmetrical limb weakness and areflexia. GBS can have different clinical manifestations; hence, the initial symptoms are also varied. Here, we describe a rare case of GBS presenting as hemiparesis and cranial nerve palsy, which mimic brainstem stroke.Case Presentation: A 53-year-old man was admitted to the hospital with a 3-h history of left-arm weakness, glossolalia, and right eyelid droop. After admission, his condition suddenly worsened, with quadriplegia, bilateral peripheral facial palsy, bilateral ophthalmoplegia, and other neurological symptoms. Based on the findings from a neurological examination, MRI, cerebrospinal fluid analysis, and nerve conduction study, a diagnosis of GBS was made. He received intravenous immunoglobulin (0.4 kg/day) for 5 days. After 20 days of systematic therapy, his dysphagia, dyspnea, facial paralysis, ocular movement disorder, and leg weakness recovered almost completely, but his arms were still moderately impaired, with a power of 4/5. Fortunately, the patient recovered well without any sequelae after 2 years of follow-up.Conclusions: In patients with an atypical presentation, the diagnosis of GBS is often delayed. With this case report, we intend to highlight the fact that some symptoms mimicking stroke may be a feature of GBS at onset; close observation and timely diagnosis are crucial for clinicians. Neuroimaging is a valuable diagnostic tool in differentiating stroke from GBS.


Author(s):  
Mohamed Reda Belkhribchia ◽  
Abderrahim Chekabab ◽  
Yahya Naji ◽  
Latifa Hadrane ◽  
Soufiane Hassar ◽  
...  

Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy. Progressive limb weakness, diminished/absent reflexes, sensory disturbance, and variable autonomic dysfunction are its core clinical manifestations. Bifacial weakness with paraesthesias (BFP) is a rare regional variant of GBS and is characterized by simultaneous facial diplegia, distal paraesthesias and minimal or no motor weakness. The association of headache with classic GBS has been rarely reported in the literature, and has not yet been described in the BFP variant. Here we report a misleading case of BFP variant associated with severe headache and mild pleocytosis. The repetition of nerve conduction studies (NCS) was extremely beneficial in this confusing case.


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiaoyu Gong ◽  
Shuping Liu ◽  
Yin Liu ◽  
Jiajia Yao ◽  
Xiujuan Fu ◽  
...  

Abstract Background Surgery is a potential trigger of Guillain-Barré syndrome (GBS), a disorder which leads to an autoimmune-mediated attack of peripheral nerves. The present study was designed to explore clinical features of post-surgical GBS compared with those of general GBS in order to provide better clinical advice to patients undergoing surgery. Methods The medical records of GBS patients who were seen at 31 tertiary hospitals in southern China between January 1, 2013 and September 30, 2016 were retrospectively analyzed. Post-surgical GBS was defined as symptoms of GBS within 6 weeks after surgery. Clinical features of post-surgical GBS are described and are compared with general GBS. Results Among the 1001 GBS patient cases examined in this study, 45 (4.5%) patient cases exhibited symptoms of GBS within 6 weeks of undergoing surgery. Within this group, 36 (80.0%) patients developed initial symptoms of limb weakness. The average interval between surgery and symptom onset was 13.31 days. The most common type of surgery which triggered GBS was orthopedic surgery, followed by neurological surgery. Compared to general GBS, post-surgical GBS was characterized by a higher proportion of severe patients (Hughes functional grading scale (HFGS) score ≥ 3) upon admission and at nadir, higher HFGS scores at discharge, and longer hospital stays. Post-surgical GBS patients also had a significantly higher frequency of the acute motor axonal neuropathy subtype (37.9 vs. 14.2, respectively; P = 0.001). Conclusion Surgery is probably a potential trigger factor for GBS, especially orthopedic surgery. Infections secondary to surgery may play a role. The possibility of preceding (post-operative) infections was not excluded in this study. Clinical presentation of post-surgical GBS is characterized by a more severe course and poorer prognosis, and should be closely monitored. Trial registration chicTR-RRc-17,014,152.


2021 ◽  
Vol 100 (2) ◽  
pp. 284-287
Author(s):  
E.S. Druzhinina ◽  
◽  
R.T. Bembeeva ◽  
D.S. Druzhinin ◽  
U.M. Azizova ◽  
...  

The article presents a description of an overlap syndrome, rare in pediatric practice, associated with antibodies to glutamic acid decarboxylase in a 4-year-old child, which was initially regarded as a variant of Guillain–Barré syndrome due to the similarity of clinical manifestations.


2014 ◽  
Vol 2 (1) ◽  
pp. 48-49
Author(s):  
Poly Sengupta ◽  
Rama Biswas ◽  
Hasan Shahrear Ahmed ◽  
Kaniz Fatema

Guillain- Barrè Syndrome is characterized by acute progressive symmetric limb weakness and areflexia. A 32 year old female presented with progressive ascending areflexic muscular weakness and bilateral lower motor neuron type of facial palsy. She had anorexia, nausea and upper abdominal pain for 2 weeks. The findings of motor nerve conduction study are consistent with acute inflammatory demyelinating polyradiculoneuropathy. She had elevated liver enzyme and positive immunoglobulin M antibody against hepatitis E in blood. Based on clinical features, laboratory findings and electrophysiological study, she was diagnosed as Guillain- Barrè Syndrome following hepatitis E. She was treated with intravenous immunoglobulin and recovered fully. DOI: http://dx.doi.org/10.3329/bccj.v2i1.19973 Bangladesh Crit Care J March 2014; 2 (1): 48-49


2021 ◽  
Vol 8 (9) ◽  
pp. 548-550
Author(s):  
Chinnu Roy ◽  
Jobin Kunjumon Vilapurathu ◽  
Dhanya Paul

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.


2019 ◽  
pp. 193-207
Author(s):  
Matthew J. G. Burford ◽  
Richard A. Lewis

This chapter begins by outlining the origin of Guillain-Barré syndrome (GBS). It looks at the epidemiology and antecedent events. It also considers clinical manifestations. The classic clinical scenario is one of acute, symmetric, progressive, ascending weakness, and areflexia, with or without sensory symptoms days to weeks after a preceding infection. Next differential diagnosis is examined. The differential diagnosis of GBS is quite broad and includes disorders leading to sudden onset of weakness. The general pattern of clinical involvement and medical history helps to hone the differential. Finally, the chapter looks at management of the syndrome and treatment options for various different groups, such as immune therapy.


2020 ◽  
Vol 13 (2) ◽  
pp. e232940 ◽  
Author(s):  
Manisha Gulia ◽  
Preeti Dalal ◽  
Monica Gupta ◽  
Daljinderjit Kaur

Dengue is an arboviral infection that classically presents with fever, headache, joint pain, skin flush and morbilliform rashes. Neurological manifestations are well recognised but their exact incidence is unknown. Though myalgias are common in dengue virus infection, myositis and/or elevated serum creatine kinase is an uncommon complication. Guillain-Barré syndrome is another rare neurological manifestation associated with dengue fever. Here, we report the case of a 21-year-old man with serologically confirmed dengue fever presenting with severe myalgia, bilateral lower and upper limb weakness with raised creatine kinase, MRI suggestive of myositis and myonecrosis and nerve conduction velocity showing bilateral lower limb and axillary sensory motor neuropathy. He was managed conservatively and made an uneventful recovery.


2019 ◽  
Vol 6 ◽  
pp. 2329048X1985677 ◽  
Author(s):  
Omar Abdel-Mannan ◽  
Luigi D’Argenzio ◽  
Matthew Pitt ◽  
Felice D’Arco ◽  
Sanjay Bhate ◽  
...  

We describe 2 pediatric cases presenting with posterior reversible encephalopathy syndrome secondary to autonomic dysfunction preceding the onset of motor symptoms in Guillain-Barré syndrome variants. Patient 1 presented acutely with encephalopathy, cerebellar signs, hypertension, lower limb weakness, and respiratory decompensation. Magnetic resonance imaging (MRI) brain showed occipital lesions consistent with posterior reversible encephalopathy syndrome. Nerve conduction studies were consistent with Miller-Fisher syndrome. After intravenous immunoglobulin and plasmapheresis, he improved clinically with radiological resolution. Patient 2 presented with headache, leg pain, seizures, and significant hypertension. Brain MRI was normal but spine MRI revealed enhancement of the cauda equina ventral nerve roots. She was areflexic with lower limb weakness a few days after intensive care unit admission and made a significant improvement after treatment with intravenous immunoglobulin. In children presenting with posterior reversible encephalopathy syndrome in the absent of other causes of primary hypertension, Guillain-Barré syndrome variants are an important differential etiology, presenting with autonomic dysfunction, even before signs of motor weakness become evident.


2020 ◽  
Vol 13 (9) ◽  
pp. e236978 ◽  
Author(s):  
Nasir Ameer ◽  
Kalyan Mansukhbhai Shekhda ◽  
Ann Cheesman

A construction worker in his 30s presented three times in 4 days with progressive upper and then lower limb weakness. On the first two occasions he had no systemic symptoms, but on the third presentation he had fever and cough, starting from day 4 of weakness. Examination identified weakness in all four limbs and areflexia, suggesting a peripheral neuromuscular disorder. Investigations were consistent with Guillain-Barré syndrome and additional COVID-19 (SARS-CoV-2) infection. The patient improved after immunoglobulin treatment. At least four cases of Guillain-Barré syndrome have been reported in the literature with concurrent COVID-19 illness in whom respiratory signs appeared a few days after the onset of neurological signs. With the incubation period for COVID-19 respiratory symptoms believed to be up to 14 days, it is possible that neurological symptoms could develop before respiratory and other symptoms. During the current pandemic, presence of concurrent COVID-19 infection needs to be considered in patients presenting with Guillain-Barré syndrome.


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