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

Atypical Clinical Presentations of Pediatric Acute Immune-Mediated Polyneuropathy

2019 ◽  
Vol 34 (5) ◽  
pp. 268-276 ◽  
Author(s):  
Naama Yosha-Orpaz ◽  
Sharon Aharoni ◽  
Malcolm Rabie ◽  
Yoram Nevo
Keyword(s):  
Axonal Neuropathy ◽  
Significant Proportion ◽  
Respiratory Muscles ◽  
Clinical Findings ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Presenting Symptoms ◽  
Tertiary Center ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis in children. During the acute phase, the disorder can be life-threatening by involving the respiratory muscles and the autonomic nervous system. Nevertheless, the prognosis is good, and most children achieve full recovery. The aim of this study was to characterize the clinical and electrophysiologic findings in children with Guillain-Barré syndrome referred to a tertiary center in Israel. A retrospective database review from 2009 to 2015 identified 39 children. Data on clinical presentation, respiratory complications, and long-term neurologic outcomes were collected. Atypical clinical findings at admission included asymmetric weakness in 23%, nonascending weakness in 30%, and normal deep tendon reflexes in 28%. Eight children were later diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Electrophysiologic findings, available in 12 patients with Guillain-Barré syndrome, revealed acute inflammatory demyelinating polyradiculoneuropathy (AIDP) in 4 (33.5%), AIDP with secondary axonal changes in 3 (25%), and acute motor axonal neuropathy (AMAN) subtype in 4 (33.5%); 8% had no abnormal findings. On follow-up, 71% of the children with Guillain-Barré syndrome fully recovered compared to 14% of the children with CIDP. Corresponding rates of neurologic sequelae were 29% and 86%. Clinicians should be alert to the atypical presenting symptoms of Guillain-Barré syndrome, which occur in a significant proportion of children.

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 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.

Study of Guillain-Barre syndrome etiology in Pakistani patients

2021 ◽  
Author(s):  
Rashid Iqbal ◽  
Muhammad Javaid Asad ◽  
Saima Siddiqi ◽  
Raja Tahir Mahmood ◽  
Muhamamd Baseer Shah ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Nerve Conduction ◽  
Treatment Strategies ◽  
Guillain Barre Syndrome ◽  
Clinical Feature ◽  
Interleukin 17 ◽  
Healthy Controls ◽  
Female Ratio ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Objective: To examine clinical features, biochemical markers, demographic features, antecedent infections, frequency and treatment strategies. Methods: This case-control study was conducted at Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan and District Headquarters Hospital (DHQ), Rawalpindi, Pakistan from 2018 to 2020. Ninety consecutive patients of Guillain-Barré syndrome (GBS) and 77 healthy controls were enrolled. Patients were diagnosed by clinical presentation, Nerve conduction study (NCS), Electromyography (EMG), Cerebrospinal fluid analysis (CSF) and biochemical profile. Data was analyzed on IBM SPSS version 23. Results: Symmetrical ascending weakness was the striking clinical feature. Mean age was 40.20±14.90 years and male to female ratio was 2.1:1. Acute inflammatory demyelinating polyneuropathy (AIDP) was found to be the most common electrophysiological variant of GBS (46%). There was considerable difference in Interleukin-17(IL-17) levels between GBS patients 23.12 ± 3.41 pg/ml and healthy controls 8.82 ± 2.49. Mean IL-17 level was markedly increased in GBS patients, P=0.006, P<0.05. Gastrointestinal infection was the most common preceding infection (56.66%). Mean CSF protein was 100.83 g/dl with ± 51.32 standard deviation and albumio cytologic dissociation (ACD) was different in all four variants of GBS, P= 0.005. Conclusion: GBS was presented by all ages. Males were more affected than females. About two third of GBS patients showed an antecedent infection before GBS onset. Increased levels of cytokine (IL-17) showed involvement of autoimmunity. ACD differentiated it from poliomyelitis. Plasmapheresis and intravenous immunoglobulin (IVIG) therapy were used to treat patients. Key words: Guillain-Barré Syndrome; cerebrospinal fluid; albuminocytologic dissociation; nerve conduction studies; variants; electromyography Continuous....

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.

Acute Motor Axonal Neuropathy in a 5-Month-Old Child

2019 ◽  
Vol 18 (03) ◽  
pp. 171-174
Author(s):  
Federica Sullo ◽  
Milena Motta ◽  
Pierluigi Smilari ◽  
Luigi Rampello ◽  
Filippo Greco ◽  
...  
Keyword(s):  
Axonal Neuropathy ◽  
Male Infant ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Fisher Syndrome ◽  
Acute Inflammatory Demyelinating Polyneuropathy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Prior Infection ◽  
Prevalent Form

AbstractGuillain–Barré syndrome (GBS) is an acute inflammatory polyneuropathy characterized by rapidly progressive, essentially symmetric weakness and areflexia in a previously otherwise healthy child. It is the most common cause of acute flaccid paralysis in children, and its reported incidence is 1 to 2/100,000 population. Prior infection is a well-established predating event in GBS. The commonly recognized variants of GBS are acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor sensory axonal neuropathy, and Miller–Fisher syndrome. AIDP is the most prevalent form. As Guillain–Barrè syndrome represents an important differential diagnosis in infancy with pronounced and progressive hypotonia, we herein report a case of AMAN in a 5-month-old male infant without known exposure to immunomodulating factors or infections.

The acute motor-sensory axonal neuropathy variant of Guillain-Barré syndrome after thoracic spine surgery

2011 ◽  
Vol 15 (6) ◽  
pp. 605-609 ◽  
Author(s):  
Jocelyn Cheng ◽  
D. Ethan Kahn ◽  
Michael Y. Wang
Keyword(s):  
Spine Surgery ◽  
Thoracic Spine ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
Classic Form ◽  
Guillain Barré ◽  
New Onset

Guillain-Barré syndrome (GBS) is the eponym used to describe acute inflammatory polyradiculoneuropathies, which manifest with weakness and diminished reflexes. Although the classic form of GBS is considered to be an ascending demyelinating polyneuropathy, several variants have been described in the literature, including the Miller-Fisher syndrome, acute panautonomic neuropathy, acute motor axonal neuropathy, and acute motor-sensory axonal neuropathy (AMSAN). Few cases of postoperative GBS have been documented, particularly for the AMSAN variant. The authors describe the case of a patient who developed AMSAN after thoracic spine surgery and highlight the importance of investigating new-onset weakness in the postoperative period.

S43. Single vs serial nerve conduction study in Guillain Barré syndrome

2018 ◽  
Vol 129 ◽  
pp. e157-e158
Author(s):  
Kongkiat Kulkantrakorn ◽  
Yuwadee Thongchuam ◽  
Puchit Sukphulloprat
Keyword(s):  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré
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