scholarly journals Guillain-Barré Syndrome During the COVID-19 Pandemic and Pre-pandemic Periods

2022 ◽  
Vol 8 (1) ◽  
pp. 33-38
Author(s):  
Alyeh Besharati ◽  
◽  
Alia Saberi ◽  
Samaneh Ghorbani Shirkouhi ◽  
Ali Ashraf ◽  
...  
Keyword(s):  
Axonal Neuropathy ◽  
Common Type ◽  
Guillain Barre Syndrome ◽  
Response To Treatment ◽  
The North ◽  
Significant Difference ◽  
Guillain Barré Syndrome ◽  
North Of Iran ◽  
Guillain Barré ◽  
Guilan Province

Background: Guillain-Barré Syndrome (GBS) is an autoimmune disease that may occur after infections. As Coronavirus Disease 2019 (COVID-19) may bring about GBS, it is important to assess the effect of the COVID-19 pandemic on this disease Objectives: This study aimed to compare the distribution and characteristics of GBS during and before the COVID-19 pandemic in an academic referral hospital in the north of Iran. Materials & Methods: This retrospective study assessed GBS distribution and characteristics during the COVID-19 pandemic period (from March 2020 to the end of February 2021) and before the pandemic (from March 2019 to the end of February 2020) on 5340 patients referred to the Neurology Ward of Poursina Hospital of Guilan Province, in Iran. Results: There was no significant difference between GBS distribution during (0.03%) and before (0.04%) the COVID-19 pandemic (P=0.413). There were also no differences between the two periods regarding the gender (P=0.659) and age (P=0.417) of the patients. The most common subtype of GBS during the COVID-19 pandemic was Acute Motor and Sensory Axonal Neuropathy (AMSAN) (71.4%). In both periods, the most common type of treatment was intravenous administration of immune globulin. There was no significant difference between the two periods (P=0.838) regarding the patients’ treatment response. Conclusion: The distribution of GBS, its subtypes, type of treatment, and response to treatment were not different between the two study periods.

scholarly journals Post-Infectious Guillain–Barré Syndrome Related to SARS-CoV-2 Infection: A Systematic Review

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 167
Author(s):  
Pasquale Sansone ◽  
Luca Gregorio Giaccari ◽  
Caterina Aurilio ◽  
Francesco Coppolino ◽  
Valentina Esposito ◽  
...  
Keyword(s):  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Guillain Barre Syndrome ◽  
Response To Treatment ◽  
Comprehensive Overview ◽  
Fisher Syndrome ◽  
Immunomodulating Therapy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

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.

scholarly journals Guillain-Barré syndrome triggered by surgery in a Chinese population: a multicenter retrospective study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiaoyu Gong ◽  
Shuping Liu ◽  
Yin Liu ◽  
Jiajia Yao ◽  
Xiujuan Fu ◽  
...  
Keyword(s):  
Clinical Features ◽  
Orthopedic Surgery ◽  
Southern China ◽  
Axonal Neuropathy ◽  
Trigger Factor ◽  
Guillain Barre Syndrome ◽  
Initial Symptoms ◽  
Guillain Barré Syndrome ◽  
Potential Trigger ◽  
Guillain Barré

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.

scholarly journals A Case of Acute Motor Sensory Axonal Neuropathy: A Variant of Guillain-Barré Syndrome, with Possible Syndrome of Irreversible Lithium-Effectuated Neurotoxicity

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
David Y. Liu ◽  
Jessica R. Hollenbach ◽  
Jason A. Gregorin ◽  
Jonathan H. Wynbrandt
Keyword(s):  
Prolonged Mechanical Ventilation ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Respiratory Compromise ◽  
Term Care ◽  
Fluid Analysis ◽  
Guillain Barré Syndrome ◽  
Immune Globulins ◽  
Prolonged Recovery ◽  
Guillain Barré

Acute Motor Sensory Axonal Neuropathy (AMSAN) is a rare and severe variant of Guillain-Barré syndrome (GBS) that has a prolonged recovery course. GBS is often suspected due to ascending muscle weakness, sensation difficulties, respiratory compromise, and antecedent diarrhea. The diagnosis of GBS is supported by cerebrospinal fluid analysis showing albuminocytologic dissociation. Electromyogram and nerve conduction study confirm the diagnosis and allow for further classification by variant. Treatment involves either IV immune globulins or plasmapheresis, and patients typically recover. However, depending on the variant and severity, patients may ultimately require prolonged mechanical ventilation with tracheostomy. In these cases, they may continue to have persistent muscle and sensation abnormalities requiring long-term care. We present a unique case of a 38-year-old female patient with decade-long use of lithium for bipolar disorder that presented with acute lithium toxicity. Though she was ultimately diagnosed with AMSAN, the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) may have also contributed to her persistent neurological sequelae.

Acute Motor-Sensory Axonal Neuropathy With Hyperreflexia in Guillain-Barré Syndrome

2014 ◽  
Vol 30 (5) ◽  
pp. 637-640 ◽  
Author(s):  
Ayşe Tosun ◽  
Şiar Dursun ◽  
Utku Ogan Akyildiz ◽  
Seçil Oktay ◽  
Cengiz Tataroğlu
Keyword(s):  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

High-Dose Intravenous Immune Globulin in the Management of Severe Guillain-Barre Syndrome

1992 ◽  
Vol 26 (1) ◽  
pp. 32-33 ◽  
Author(s):  
Miguel Urtasun ◽  
Adolfo López de Murrain ◽  
Nieves Carrera ◽  
José F. Martí-Massó ◽  
Gonzalo López de Dicastillo ◽  
...  
Keyword(s):  
Ad Hoc ◽  
Care Center ◽  
Tertiary Care ◽  
Final Analysis ◽  
Multicenter Trial ◽  
Guillain Barre Syndrome ◽  
High Dose ◽  
The North ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

OBJECTIVE: To evaluate the efficacy of high-dose intravenous gammaglobulin (IGIV) versus plasmapheresis in patients with severe Guillain-Barré syndrome (GBS) and compare the costs of both treatments. DESIGN: Retrospective review of all severely disabled GBS patients admitted between January 1 and December 31, 1990. SETTING: Neurologic unit of a tertiary-care center. PATIENTS: Six patients fulfilling the criteria for the diagnosis of GBS agreed upon by the ad hoc National Institute of Neurological and Communicative Disorders and Stroke committee. INTERVENTION: Four patients treated with plasmapheresis underwent three to six sessions of plasma exchange. Two patients received IGIV 0.4 g/kg/d administered over a five-day period. MAIN OUTCOME MEASURES: Recovery time, functional assessment (performed according to the grading scale used in the North American trial) at 30, 60, and 90 days after treatment. Cost of plasmapheresis, IGIV, and bed/day were compared. RESULTS: Clinical recovery appeared to be faster and more complete in the IGIV group than in the plasmapheresis group. No adverse reactions related to IGIV treatment appeared. The total cost was greater in the plasmapheresis group. CONCLUSIONS: These preliminary results suggest that IGIV may be more beneficial and less expensive than plasmapheresis in treatment of GBS. Definitive conclusions regarding the efficacy of IGIV in GBS will need to await the final analysis of the Ducht randomized multicenter trial comparing IGIV with plasmapheresis.

scholarly journals Efficacy of therapies in the treatment of Guillain-Barre Syndrome: a network meta-analysis

2020 ◽  
Author(s):  
Jingfeng Lin ◽  
Qiang Gao ◽  
Kang Xiao ◽  
Danfeng Tian ◽  
Wenyue Hu ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Indirect Evidence ◽  
Guillain Barre Syndrome ◽  
Cochrane Library ◽  
Control Group ◽  
Human Beings ◽  
R Software ◽  
Significant Difference ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Abstract Background Guillain-Barre syndrome (GBS) is an acute, paralyzing, inflammatory peripheral nerve disease. For treatments of the Guillain-Barre Syndrome, there are many kinds of therapies for this diseases. For comparing all of the therapies, such as immunoglobulin, plasma exchanging, etc. in the treatment of Guillain-Barre Syndrome(GBS) to better inform clinical practice, we use Network meta analysis to get the outcome of the Guillain-Barre Syndrome. The protocol has been submitted to PROSPERO:CRD: 42019119178. Methods Web of Science, PubMed, Embase, and the Cochrane library were searched for related articles. We identified citations of these and included 26 trials comprising 2434 patients and control group human beings. Network meta-analysis (NMA) was performed with two kinds of outcomes. We carried on R software with gemtc package and JAGS software to calculate results for different therapies. The consistency of direct and indirect evidence was also assessed by R software. Results Concerning for two outcomes, there were no improvement observed in MTP and Pred compared with placebo. PE and IVIg were illustrated to be effective over Placebo. There was no significant difference between different doses and times of PE and IVIg. On consistency examination between direct and indirect evidences, there were no obvious heterogeneity between all of therapies. Funnel plots indicates the possibility of publication bias in this study are small. Conclusion PE or IVIg had a significant efficency for GBS patients. The effects of some combination treatments should be further explored. Corticosteroids had no significant effects on GBS.

scholarly journals Fulminant Guillain-Barré syndrome in a patient with systemic lupus erythematosus

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-226634 ◽  
Author(s):  
Eric Anthony Coomes ◽  
Hourmazd Haghbayan ◽  
Jenna Spring ◽  
Sangeeta Mehta
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Systemic Lupus ◽  
Outward Appearance ◽  
Intravenous Immunoglobulin Therapy ◽  
Neuropsychiatric Manifestation ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

A 45-year-old man with a history of systemic lupus erythematosus presented with progressive weakness and areflexia. Electromyogram revealed reduced motor and sensory amplitudes without demyelinating features. He was clinically diagnosed with the acute motor and sensory axonal neuropathy variant of Guillain-Barré syndrome. Despite intravenous immunoglobulin therapy, he deteriorated with loss of all voluntary motor function and cranial nerve reflexes. Concomitant investigations revealed class V lupus nephritis. Therapy was initiated with plasma exchange, glucocorticoids and further immunosuppression, with gradual neurological recovery. We present the first documented case of fulminant Guillain-Barré syndrome as a neuropsychiatric manifestation of systemic lupus erythematosus, highlighting how immune-mediated polyneuropathy via diffuse deafferentation may mimic the outward appearance of brain death. While glucocorticoids are not indicated in idiopathic Guillain-Barré, when this neurological disorder is a consequence of systemic lupus erythematosus, immunomodulatory treatment should be initiated to prevent neurological deterioration.

scholarly journals Electrophysiology in the Guillain-Barré Syndrome: Study of 30 Cases

1970 ◽  
Vol 24 (2) ◽  
pp. 54-60
Author(s):  
NC Kundu
Keyword(s):  
Cell Count ◽  
Electrophysiological Study ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Elevated Protein ◽  
Guillain Barré Syndrome ◽  
A Cell ◽  
Guillain Barré

Thirty consecutive patients diagnosed clinically as Guillain Barré Syndrome (GBS) were enrolled in this study to see the electrophysiological patterns of GBS in Bangladeshi community. Among 30 patients, 25 were male (M: F = 5:1) and 47% patients were between 16 and 25 years of age. An antecedent event was present in 67% of patients. An elevated protein was present in 90% of cases and a cell count of up to five was present in 94% of patients. Acute inflammatory demyelinating polyradiculopathy (AIDP) was commonest (33.35%) followed by acute motor axonal neuropathy (AMAN) which constitute 26% of patients in electrophysiological study of the enrolled patients. Acute motor sensory axonal neuropathy constitutes 14% of cases in this series. (J Bangladesh Coll Phys Surg 2006; 24: 54-60)

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.

Sign in / Sign up

Export Citation Format

Share Document