scholarly journals Case Report: Abnormal ECG and Pantalgia in a Patient With Guillain–Barré Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiangqi Cao ◽  
Manyun Tang ◽  
Hui Liu ◽  
Xin Yue ◽  
Guogang Luo ◽  
...  
Keyword(s):  
Chest Pain ◽  
Guillain Barre Syndrome ◽  
Limb Weakness ◽  
Coronary Syndrome ◽  
Left Anterior Descending Artery ◽  
Wave Inversion ◽  
Guillain Barré Syndrome ◽  
Sensory Disturbances ◽  
Artery Disease ◽  
Guillain Barré

Background: Guillain–Barré syndrome (GBS) is an acute immune-mediated disorder in the peripheral nervous system (PNS) characterized by symmetrical limb weakness, sensory disturbances, and clinically absent or decreased reflexes. Pantalgia and dysautonomia, including cardiovascular abnormalities, are common findings in the spectrum of GBS. It is usually challenging to distinguish GBS-related electrocardiogram (ECG) abnormities and chest pain from acute coronary syndrome (ACS) in patients with GBS due to the similar clinical symptom and ECG characteristics. Here, we present a case of GBS complicating ACS.Case Summary: A 37-year-old woman with a 2-month history of GBS presented to the emergency department due to pantalgia. The ECG showed a pattern of transitional T-wave inversion in the leads I, aVL, and V2 through V4 and shortly returned to normal, which appeared several times in a short time, but lab testing was unremarkable. Then, a further coronary computed tomography angiography (CTA) revealed the presence of critical stenosis of the left anterior descending artery, leading to the diagnosis of ACS. During the follow-up, she suffered from a non-ST-elevation myocardial infarction and accepted revascularization of the left anterior descending artery in the second week after discharge.Conclusion: Guillain–Barré syndrome could accompany chest pain and abnormalities on ECG. Meanwhile, it is essential to bear in mind that “GBS-related ECG abnormalities and chest pain” is a diagnosis of exclusion that can only be considered after excluding coronary artery disease, especially when concomitant chest pain, despite being a common presentation of pantalgia, occurs.

scholarly journals Guillain-Barré syndrome in SARS-CoV-2 infection: an instant systematic review of the first six months of pandemic

2020 ◽  
Vol 91 (10) ◽  
pp. 1105-1110 ◽  
Author(s):  
Antonino Uncini ◽  
Jean-Michel Vallat ◽  
Bart C Jacobs
Keyword(s):  
Systematic Review ◽  
Guillain Barre Syndrome ◽  
Nasopharyngeal Swab ◽  
Time Interval ◽  
Limb Weakness ◽  
Small Series ◽  
Diagnostic Certainty ◽  
Guillain Barré Syndrome ◽  
Sensory Disturbances ◽  
Guillain Barré

A systematic review from 1 January to 30 June 2020 revealed 42 patients with Guillain-Barré syndrome (GBS) associated with SARS-CoV-2 infection. Single cases and small series were reported from 13 countries, the majority from Europe (79.4%) and especially from Italy (30.9%). SARS-CoV-2 infection was demonstrated by nasopharyngeal swab (85.7%) and serology (14.3%). Median time between COVID-19 and GBS onset in 36 patients was 11.5 days (IQR: 7.7–16). The most common clinical features were: limb weakness (76.2%), hypoareflexia (80.9 %), sensory disturbances (66.7 %) and facial palsy (38.1%). Dysautonomia occurred in 19%, respiratory failure in 33.3% and 40.5% of patients were admitted in intensive care unit. Most patients (71.4%) had the classical clinical presentation but virtually all GBS variants and subtypes were reported. Cerebrospinal fluid (CSF) albumin-cytological dissociation was found in 28/36 (77.8%) and PCR for SARS-CoV-2 was negative in 25/25 patients. Electrodiagnosis was demyelinating in 80.5% and levels 1 and 2 of Brighton criteria of diagnostic certainty, when applicable, were fulfilled in 94.5% patients. Antiganglioside antibodies were positive in only 1/22 patients. Treatments were intravenous immunoglobulin and/or plasma exchange (92.8%) with, at short-time follow-up, definite improvement or recovery in 62.1% of patients. One patient died. In conclusion, the most frequent phenotype of GBS in SARS-CoV-2 infection is the classical sensorimotor demyelinating GBS responding to the usual treatments. The time interval between infectious and neuropathic symptoms, absence of CSF pleocytosis and negative PCR support a postinfectious mechanism. The abundance of reports suggests a pathogenic link between SARS-CoV-2 infection and GBS but a case-control study is greatly needed.

scholarly journals Guillain –Barrè Syndrome following Hepatitis E

2014 ◽  
Vol 2 (1) ◽  
pp. 48-49
Author(s):  
Poly Sengupta ◽  
Rama Biswas ◽  
Hasan Shahrear Ahmed ◽  
Kaniz Fatema
Keyword(s):  
Motor Nerve ◽  
Electrophysiological Study ◽  
Hepatitis E ◽  
Immunoglobulin M ◽  
Guillain Barre Syndrome ◽  
Limb Weakness ◽  
Laboratory Findings ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Upper Abdominal

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

Case Report on Guillain Barre Syndrome: Acute Inflammatory Demyelinating Polyneuropathy

2021 ◽  
Vol 8 (9) ◽  
pp. 548-550
Author(s):  
Chinnu Roy ◽  
Jobin Kunjumon Vilapurathu ◽  
Dhanya Paul
Keyword(s):  
Case Report ◽  
Medical Condition ◽  
Demyelinating Polyneuropathy ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Limb Weakness ◽  
Acute Inflammatory Demyelinating Polyneuropathy ◽  
Guillain Barré Syndrome ◽  
Inflammatory Demyelinating Polyneuropathy ◽  
Guillain Barré

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.

scholarly journals Concurrent Guillain-Barré syndrome and myositis complicating dengue fever

2020 ◽  
Vol 13 (2) ◽  
pp. e232940 ◽  
Author(s):  
Manisha Gulia ◽  
Preeti Dalal ◽  
Monica Gupta ◽  
Daljinderjit Kaur
Keyword(s):  
Creatine Kinase ◽  
Dengue Fever ◽  
Elevated Serum ◽  
Guillain Barre Syndrome ◽  
Uneventful Recovery ◽  
Motor Neuropathy ◽  
Limb Weakness ◽  
Guillain Barré Syndrome ◽  
Bilateral Lower Limb ◽  
Guillain Barré

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.

scholarly journals Two Cases of Guillain-Barré Syndrome Variants Presenting With Dysautonomia

2019 ◽  
Vol 6 ◽  
pp. 2329048X1985677 ◽  
Author(s):  
Omar Abdel-Mannan ◽  
Luigi D’Argenzio ◽  
Matthew Pitt ◽  
Felice D’Arco ◽  
Sanjay Bhate ◽  
...  
Keyword(s):  
Intravenous Immunoglobulin ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Lower Limb ◽  
Guillain Barre Syndrome ◽  
Limb Weakness ◽  
Posterior Reversible Encephalopathy ◽  
Lower Limb Weakness ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Reversible Encephalopathy

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.

scholarly journals Guillain-Barré syndrome presenting with COVID-19 infection

2020 ◽  
Vol 13 (9) ◽  
pp. e236978 ◽  
Author(s):  
Nasir Ameer ◽  
Kalyan Mansukhbhai Shekhda ◽  
Ann Cheesman
Keyword(s):  
Neuromuscular Disorder ◽  
Guillain Barre Syndrome ◽  
Limb Weakness ◽  
Neurological Signs ◽  
The Third ◽  
Lower Limb Weakness ◽  
Guillain Barré Syndrome ◽  
Immunoglobulin Treatment ◽  
Systemic Symptoms ◽  
Guillain Barré

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.

scholarly journals Paralytic ileus as the presenting symptom for Guillain–Barré syndrome: a case report

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051989316
Author(s):  
Kuang-Heng Lee ◽  
Tsung-Han Ho ◽  
Jiunn-Tay Lee ◽  
Li-Fan Lin ◽  
Wei-Chou Chang ◽  
...  
Keyword(s):  
Paralytic Ileus ◽  
Early Recognition ◽  
Early Stage ◽  
Immunoglobulin Therapy ◽  
Guillain Barre Syndrome ◽  
Rapid Progression ◽  
Limb Weakness ◽  
Intravenous Immunoglobulin Therapy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Guillain–Barré syndrome (GBS) is an acute neuroimmunological disorder characterized by rapidly ascending symmetrical limb weakness, areflexia, and sensory deficits. Approximately 65% of patients with GBS present with autonomic dysfunction, which commonly occurs in advanced stages. However, paralytic ileus, a sign of gastrointestinal dysautonomia, is rare as the presenting feature in GBS before motor weakness becomes evident. We report the case of a 54-year-old man admitted to the Emergency Department with paralytic ileus as the prodromal feature in early-stage GBS. Total parenteral feeding and prokinetic use were initiated, but no clinical improvement was observed. The patient showed rapid progression to quadriplegia, which was ultimately determined to be respiratory muscle failure requiring mechanical ventilation and intensive care unit admission. He underwent 5 days of intravenous immunoglobulin therapy and muscle strength was partially improved thereafter. However, the patient’s enteral nutritional support was undesirable because of persistent poor gastric emptying complicated by fungemia and profound sepsis throughout the hospital course. Finally, he died 1 month after admission. Ignorance of this unusual prodrome to GBS could result in delayed treatment, along with potential progression to life-threatening events. Early recognition of GBS and prompt immunotherapy are critical for reducing morbidity and mortality.

scholarly journals Miller-Fisher Syndrome and Guillain-Barre Syndrome overlap syndrome in a patient post Oxford-AstraZeneca SARS-CoV-2 vaccination

2021 ◽  
Vol 14 (11) ◽  
pp. e246701
Author(s):  
Yew Li Dang ◽  
Alexander Bryson
Keyword(s):  
Overlap Syndrome ◽  
Miller Fisher Syndrome ◽  
Guillain Barre Syndrome ◽  
Oculomotor Nerve Palsy ◽  
Limb Weakness ◽  
Patient Counselling ◽  
Fisher Syndrome ◽  
Facial Diplegia ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

We describe a patient who developed bilateral oculomotor nerve palsy, ataxia, facial diplegia and lower limb weakness 2 weeks post-Oxford-AstraZeneca SARS-CoV2 vaccination, consistent with Miller-Fisher syndrome (MFS) and Guillain-Barre syndrome (GBS) overlap syndrome. Although some features of the patient’s presentation were typical of recently reported cases of a rare GBS variant post-Oxford-AstraZeneca vaccination, including severe facial weakness and a lack of respiratory involvement, to our knowledge this is the first reported case of MFS associated with SARS-CoV2 vaccination. While postvaccination GBS remains rare, it appears to have a favourable prognosis, and recognising this entity is therefore important for patient counselling and monitoring for potential complications.

Sign in / Sign up

Export Citation Format

Share Document