scholarly journals A case of guillain-barré syndrome associated with post-covid infection during 2nd wave of coronavirus in india

2021 ◽  
pp. 342-344
Author(s):  
Anil Kumar Behera ◽  
Syed Naqueeb ul Hassan ◽  
Chaitanya Challa ◽  
K Divya Madhusudhan Reddy ◽  
V Bharat R Bhardwaj ◽  
...  
Keyword(s):  
Axonal Neuropathy ◽  
Inflammatory Cells ◽  
Multiple Organ ◽  
Guillain Barre Syndrome ◽  
Polymerase Chain Reaction Test ◽  
Immune Mediated ◽  
Organ Systems ◽  
Patient Reported ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

The novel coronavirus-COVID-19 was detected in Wuhan city of Hubei Province in China on December 31, 2019. Coronaviruses are known to infect multiple organ systems, with respiratory complications being the most obvious symptoms. Although, neurological manifestations are quite rarely reported in cases of COVID-19. In this report, we present the case of a 57-year-old male patient reported with complaints of acute progressive symmetric quadriparesis and recently recovered from COVID-19. Two weeks prior to hospitalization, the patient suffered from cough and fever. The reverse transcriptase-polymerase chain reaction test for COVID-19 infection was positive. Electrodiagnostic tests showed that the patient had acute motor and sensory axonal neuropathy variant of Guillain-Barré Syndrome (GBS). COVID-19 virus stimulates the inflammatory cells and as a result, creates immune-mediated processes. GBS is an immune-mediated disorder. It is not clear whether COVID-19 infection induces the production of antibodies against specific gangliosides. Further investigations should be conducted in regards to the mechanism of GBS in patients with COVID-19 in the future.

scholarly journals Guillain-Barré syndrome in a child with COVID-19 associated multi system inflammatory syndrome

2021 ◽  
Vol 8 (11) ◽  
pp. 1890
Author(s):  
Alekhya Erubothu ◽  
Sudha Rudrappa ◽  
Pratibha Manjunath Patagar
Keyword(s):  
Axonal Neuropathy ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
High Grade Fever ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Paediatric Age ◽  
Guillain Barré ◽  
High Index Of Suspicion ◽  
Inflammatory Syndrome

Multi-system inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 is a new entity affecting a small percentage of children during the COVID-19 pandemic. This usually presents with multi-organ dysfunction, predominantly affecting cardiovascular, muco-cutaneous, and gastrointestinal systems. Till now, neurological manifestations as a part of this spectrum, such as, encephalopathy, inflammatory CNS syndromes, cerebrovascular disease, and Guillain-Barré syndrome (GBS), have been well reported in adults, but there is a paucity of data from the paediatric age group. Here, we present a case of a 6-year-old girl who presented to us with progressive, bilaterally symmetrical ascending weakness of lower limbs followed by upper limbs along with drooling of saliva and dyspnea. Nerve conduction studies showed motor axonal neuropathy suggestive of GBS and child was treated accordingly with intravenous immunoglobulin. On 4th day of admission, the child developed high grade fever spikes, hypotension and diarrhoea. Hence, worked up for MIS-C which revealed elevated inflammatory markers with positive SARS-CoV-19 IgM, IgG antibodies. The diagnosis was hence revised to GBS with MIS-C, the child was then started on methylprednisolone following which the child showed both clinical and biochemical improvement and was then discharged. A high index of suspicion for the possibility of MIS-C should be kept in mind in the present pandemic times, as the immune-mediated damages in MIS-C are potentially treatable with a timely institution of intensive care measures along with the use of steroids, IV-Ig, and plasmapheresis.

Case 23

2018 ◽  
Author(s):  
Bashar Katirji
Keyword(s):  
Axonal Neuropathy ◽  
Recovery Phase ◽  
Clinical Findings ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Fisher Syndrome ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Diagnostic Sensitivity And Specificity ◽  
Guillain Barré

Guillain-Barré syndrome is the prototype of acute immune-mediated neuropathies. Guillain-Barré syndrome has several subtypes including acute inflammatory demyelinating polyneuropathy, acute motor axonal neuropathy, and acute motor sensory axonal neuropathy. Guillain-Barré syndrome has also several variants including Miller Fisher syndrome, ataxic form, and pharyngeal–cervical–brachial form. This case highlights the clinical findings in Guillain-Barré syndrome and discusses in details the diagnostic criteria that are essential in confirming the diagnosis and excluding mimickers of the disorder. This is followed by a detailed discussion on the electrodiagnostic findings in Guillain-Barré syndrome during the acute presentation and recovery phase. The diagnostic sensitivity and specificity of the various findings seen on nerve conduction studies are included.

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

scholarly journals Reworsening of Recurrent Guillain-Barré Syndrome Triggered by COVID-19 Infection

2021 ◽  
Vol 15 (1) ◽  
pp. 48-51
Author(s):  
Gian Luca Vita ◽  
Carmen Terranova ◽  
Maria Sframeli ◽  
Antonio Toscano ◽  
Giuseppe Vita
Keyword(s):  
Viral Infection ◽  
Neurological Diseases ◽  
Intravenous Immunoglobulins ◽  
Guillain Barre Syndrome ◽  
Case Presentation ◽  
Appropriate Treatment ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Introduction: Guillain-Barré Syndrome (GBS) is an acute, immune-mediated, generalized polyradiculoneuropathy often triggered by a bacterial or viral infection, vaccination, or surgery. During the SARS-CoV-2 pandemic, some patients were reported with GBS associated COVID-19 infection. Case Presentation: We report, herein, a patient who had a recurrent GBS after forty years. Intravenous immunoglobulins (IVIg) induced improvement, but her condition worsened suddenly after twenty days, coinciding with a COVID-19 infection. A second IVIg cycle was administered, and she improved again. Conclusion: The take-home message is that in the current pandemic, any re-worsening or lack of improvement after appropriate treatment of GBS or possibly other autoimmune neurological diseases must be checked to determine if it is related to COVID-19 infection.

scholarly journals Colistin neurotoxicity mimicking Guillain-Barré syndrome in a patient with cystic fibrosis: case report and review

2021 ◽  
Vol 2021 (9) ◽  
Author(s):  
Celeste Camargo ◽  
Tathagat Narula ◽  
Daniel A Jackson ◽  
Teresa Padro ◽  
W David Freeman
Keyword(s):  
Cystic Fibrosis ◽  
Drug Toxicity ◽  
Clinical Presentation ◽  
Guillain Barre Syndrome ◽  
Drug Induced ◽  
Common Presentation ◽  
Intravenous Treatment ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

ABSTRACT Guillain-Barré syndrome (GBS) is an immune-mediated polyneuropathy, which is characterized by areflexia and ascending paresthesia which can progress to a respiratory failure. Certain conditions, such as vasculitis and heavy metal and drug toxicity, may have misleadingly similar clinical presentation to GBS. We describe a case of a patient with cystic fibrosis and intravenous colistin-induced neurotoxicity mimicking GBS. The patient had used inhaled colistin on five occasions with no adverse effects, however, developed symptoms on the second day of intravenous treatment. Overlapping findings between immune-mediated polyneuropathy and drug-induced neurotoxicity include limb paresthesia and decreased reflexes. Perioral tingling, however, is a common presentation of colistin-induced neurotoxicity, and therefore, is an important differentiating factor. Early diagnosis prevents further neurologic decline, extensive unnecessary workup and potentially harmful incorrect management.

scholarly journals Patients’ experiences and perceptions of Guillain-Barré syndrome: A systematic review and meta-synthesis of qualitative research

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245826
Author(s):  
Despina Laparidou ◽  
Ffion Curtis ◽  
Joseph Akanuwe ◽  
Jennifer Jackson ◽  
Timothy L. Hodgson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Guillain Barre Syndrome ◽  
Link Type ◽  
Immune Mediated ◽  
Acceptable Quality ◽  
Guillain Barré Syndrome ◽  
Internet Searches ◽  
Guillain Barré ◽  
Full Text Screening

Background Guillain-Barré syndrome (GBS) is an immune-mediated polyradiculoneuropathy, with an incidence of 1-2/100,000 per year. Its severity is variable, ranging from very mild cases with brief weakness to severe paralysis, leading to inability to breathe independently, or even death. Currently there is limited evidence exploring the experiences of GBS patients. The aim of this study was to review patients’ experiences and perceptions of GBS and its variants at diagnosis, discharge and during recovery, by conducting a systematic review and thematic meta-synthesis of qualitative studies of patients’ experiences of GBS (and its variants). Methods We searched twelve electronic databases, supplemented with internet searches and forward and backward citation tracking from the included studies and review articles. Data were synthesised thematically following the Thomas and Harden approach. The CASP Qualitative Checklist was used to assess the quality of the included studies of this review. Results Our search strategy identified a total of 5,282 citations and after removing duplicates and excluding citations based on title and abstract, and full-text screening, five studies were included in the review and meta-synthesis; all included studies were considered of acceptable quality. Through constant discussions and an iterative approach, we developed six analytical themes following a patient’s journey from suspecting that they had a health problem, through to being hospitalised, experiencing ongoing difficulties, slowly recovering from GBS, adjusting to their new circumstances, and re-evaluating their lives. Conclusions Despite the variety of experiences, it was evident from all included studies that being diagnosed with and surviving GBS was a life-changing experience for all participants. Trial registration Protocol was registered (CRD42019122199) on the International Prospective Register of Systematic Reviews (http://www.crd.york.ac.uk/PROSPERO).

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.

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