scholarly journals Case Report: Acute Bulbar Palsy Plus Syndrome: A Guillain-Barré Syndrome Variant More Prone to Be a Subtype Than Overlap of Distinct Subtypes

2020 ◽  
Vol 11 ◽  
Author(s):  
Qian Cao ◽  
Hong Chu ◽  
Xiujuan Fu ◽  
Jiajia Yao ◽  
Zheman Xiao ◽  
...  
Keyword(s):  
Facial Palsy ◽  
Case Reports ◽  
Cranial Nerves ◽  
Case Series ◽  
Guillain Barre Syndrome ◽  
Bulbar Palsy ◽  
Guillain Barré Syndrome ◽  
Diagnostic Framework ◽  
Accompanying Symptoms ◽  
Guillain Barré

Objective: Acute bulbar palsy plus (ABPp) syndrome is a rare regional variant of Guillain-Barré syndrome (GBS) characterized by acute bulbar palsy combined with other cranial symptoms or ataxia without limb and neck weakness. We aim to investigate characteristics of ABPp syndrome and analyze its nosological position within the GBS spectrum.Methods: A patient with ABPp syndrome was reported, and previous case reports of patients who met the criteria for ABPp syndrome from the literature were reviewed.Results: A total of 28 patients were included in our study. Median age was 32 years. Most of the patients (78.6%) were from Asia, and 75.0% had preceding infection. The main accompanying symptoms were ophthalmoplegia (85.7%), facial palsy (60.7%), and ataxia (50.0%). There existed asymmetric weakness in the form of unilateral facial palsy (32.1%) and ptosis (3.6%). Approximately half of the patients had albuminocytological dissociation. All the tested patients were seropositive for antiganglioside antibodies, of which the two most common were immunoglobulin G (IgG) anti-GT1a (77.3%) and anti-GQ1b (59.1%) antibodies. Over one-third of the patients who underwent electrophysiological assessment showed subclinical neuropathy beyond cranial nerves. The outcome was generally favorable as 89.3% of patients made full recovery within 5 months.Conclusion: The hitherto largest case series of ABPp syndrome advances our understanding of this disease. Serologically, the presence of IgG anti-GT1a and anti-GQ1b antibodies predicts and contributes to the disease. Phenotypically, ABPp syndrome is more prone to be a separate subtype of GBS than overlap of distinct subtypes and has the potential to complement current diagnostic framework of GBS.

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 barre syndrome and its association with covid-19 infection – A clinical case series

2022 ◽  
Vol 7 (4) ◽  
pp. 326-333
Author(s):  
Madhavi Karri ◽  
Deepak Jacob ◽  
Balakrishnan Ramasamy ◽  
Santhosh Perumal
Keyword(s):  
Intravenous Immunoglobulin ◽  
Nerve Conduction ◽  
Cranial Nerves ◽  
Case Series ◽  
Nerve Conduction Studies ◽  
Guillain Barre Syndrome ◽  
Nasopharyngeal Swab ◽  
Neurological Manifestations ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

A novel coronavirus (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARs-CoV-2). This pandemic has been globally alarming in the current period. Several neurological manifestations are reported occurring with the infection. Guillain barre syndrome (GBS) or acute onset inflammatory polyradiculoneuropathy has been among the frequent manifestations observed among them. To know the pattern and outcome of GBS in COVID-19 affected individuals. We have taken six individuals admitted with flaccid quadriparesis in the last two months. All were affected recently by COVID 19 infection, which RT PCR of the nasopharyngeal swab confirmed. The study participants have undergone nerve conduction studies and have been diagnosed with Guillain Barre syndrome using Brighton criteria. We did cerebrospinal fluid (CSF) analysis after admission. We initiated all patients on Intravenous immunoglobulin according to body weight (2g/kg divided over five days). We used the Barthel index score to assess the outcome of the individuals. We observed a mean duration of 18.25 days between the COVID-19 infection and the onset of symptoms. Apart from motor quadriparesis and sensory symptoms being in common, we also noticed cranial nerves and autonomic involvement. We made the diagnosis using the nerve conduction studies and Brighton criteria. After initiating intravenous immunoglobulin, all patients had a good outcome, and quality of life was better after two months of follow up. Guillain Barre syndrome is one of the neurological manifestations of COVID-19 and has a dramatic response with intravenous immunoglobulin and better outcome with treatment.

scholarly journals Guillain Barré Syndrome and its variants as a manifestation of COVID-19: A systematic review of case reports and case series

2021 ◽  
Vol 420 ◽  
pp. 117263
Author(s):  
Shitiz Sriwastava ◽  
Saurabh Kataria ◽  
Medha Tandon ◽  
Jenil Patel ◽  
Riddhi Patel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

scholarly journals COVID-19 infection complicated by Guillain-Barre Syndrome: a systematic review of clinical features, pathogenic mechanism, and respiratory failure

2021 ◽  
Vol 9 (1) ◽  
pp. 34-34
Author(s):  
Mahya Khaki ◽  
Parastoo Dehghan ◽  
Naghmeh Malekzadeh ◽  
Mohsen Khamoushi ◽  
Fahimehalsadat Shojaei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Respiratory Failure ◽  
Clinical Features ◽  
Case Reports ◽  
Case Series ◽  
Diagnostic Workup ◽  
Guillain Barre Syndrome ◽  
World Health ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Background: The World Health Organization (WHO) declared a pandemic in March 2020 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Given the neurotropism feature of the coronavirus and growing number of COVID-19 associated neurological disorders, including Guillain Barre syndrome (GBS), we conducted a systematic review to thoroughly describe the clinical features, diagnostic workup, and clinical outcome of COVID-19 associated GBS in 78 cases. Methods: We identified case reports and case series of COVID-19 associated GBS by conducting a search in the PubMed/MEDLINE and EMBASE databases. We assessed the quality of studies using an appraisal checklist presented by Cochrane Murad et al. Extracted data included demographic characteristics, clinical presentation, diagnostic workup, and outcome. Results: The systematic search yielded a total of 60 articles reporting 78 patients with a diagnosis of COVID-19 associated GBS. The patients were mainly male (65.3%) with an average age of 57 years. The ascending symmetrical paresis was the most common presentation (79.4%), with demyelinating pattern in 54 patients (79.4%). The CSF analysis showed albuminocytologic dissociation in 48 patients (75%). The mortality of COVID-19 associated GBS was estimated as 6.4% attributable to progressive respiratory failure. Conclusion: Given the associated morbidities such as respiratory failure in patients with COVID-19 associated GBS, its timely detection is crucial to prevent poor clinical outcomes. On the other hand, clinicians must be vigilant to identify the clinical findings of SARS-CoV-2 infection in newly diagnosed GBS patients, as this might be a neurological complication of the subclinical viral infection.

scholarly journals Guillain-Barré Syndrome and Hyperreflexia: a case report

2021 ◽  
Author(s):  
Gabriel Santaterra Barros ◽  
Ana Paula Ramires Chiminazzo ◽  
Maria Luiza Ricarte Ruggeri ◽  
Maria Luisa Pelaes Stipp ◽  
Helen Maia Tavares de Andrade
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Cranial Nerves ◽  
Muscle Group ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Clinical Criteria ◽  
Distal Muscle ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Context: areflexia and hyporeflexia are mandatory clinical criteria for the diagnosis of Guillain-Barré Syndrome (GBS). However there are case reports in literature of GBS that exhibit hyperreflexia. Case report: Male patient, 38 years old, after weakness and pain in lower limbs, after exercise, for 4 days, without alteration of balance and sphincter. A week earlier, he had diarrhea and fever. Previous bariatric surgery. On examination: For both upper limbs, the grade of power was 5/5 in the proximal muscle group and 4/5 in the distal muscle group. For the lower limbs, the grade of power was 4/5 in both proximal and distal muscle groups. The deep tendon reflexes were brisk (+2) throughout all four limbs. Patellar tendon reflex had bigger response (+3). Babinski’s and Hoffmann’s signs were negative. Tactile, painful, vibrating sensitivity and cranial nerves examination were all intact. The presence of reflex in the four limbs with patellar hyperreflexia, made the GBS hypothesis to be disregarded. Laboratory: normal CK, TGO, aldolase, TGP, LDH and vitamin B12. Electroneuromyography (ENMG) revealed the diagnosis of AMAN. After ENMG, cerebrospinal fluid known as leukocytes: 3.1 mm³, proteins: 95.2 mg/dl. Human immunoglobulin (0.4 g/ kg/day) was prescribed for 5 days and the patient recovered in 3 months. Conclusions: The case reported by us shows the importance to take into account the GBS hypothesis in the presence of hyperreflexia, especially in axonal variants, to prevent the treatment from being mistakenly postponed.

scholarly journals Guillain Barre syndrome as a complication of SARS-CoV-2 infection: A case reports

2021 ◽  
pp. 102672
Author(s):  
Ghizlane El aidouni ◽  
Salma Touihar ◽  
Mohammed Aabdi ◽  
Manal Merbouh ◽  
Abderrahim El Kaouini ◽  
...  
Keyword(s):  
Case Reports ◽  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

SERIAL NERVE CONDUCTION STUDIES IN A GUILLAIN-BARRÉ SYNDROME VARIANT: THE EVOLUTION OF DEMYELINATING CHANGES

2015 ◽  
Vol 86 (11) ◽  
pp. e4.158-e4
Author(s):  
Catherine Morgan ◽  
Benjamin Wakerley ◽  
Geraint Fuller
Keyword(s):  
Nerve Conduction ◽  
Case Series ◽  
Pathological Process ◽  
Nerve Conduction Studies ◽  
Guillain Barre Syndrome ◽  
Facial Weakness ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Underlying Pathology ◽  
Serial Assessments

Guillain Barré syndrome (GBS) varies both in terms of clinical phenotype and underlying pathology. Serial assessments allow greater understanding of the pathophysiology. The evolution of neurophysiological changes is particularly helpful in distinguishing between demyelination and reversible axonal conduction failure.Bilateral facial weakness with distal paraesthesias is a rare subtype of GBS. In the largest case series 64% had abnormalities in motor and 27% in sensory conduction on single neurophysiological assessments; this was interpreted as a demyelinating neuropathy.We report an 18-year-old male with bilateral lower motor neurone facial weakness preceded by distal paraesthesias following a ‘flu-like illness. Examination of power and sensation was normal. Deep tendon reflexes were present. Cerebrospinal fluid showed albuminocytologic dissociation. By 6 weeks his facial weakness had almost completely resolved without treatment.Serial nerve conduction studies were performed. The first study (day 4) found prolonged distal motor latency and delayed F waves in posterior tibial and common peroneal nerves; normal sensory studies. Second study (day 18) found distal motor latencies and F waves had increased in upper and lower limb nerves. Third study (day 60) found improvement but abnormalities remained with changes similar to the first study.The neurophysiological changes became more marked while he improved clinically. These serial studies confirmed the primary pathological process of this GBS variant to be demyelination.

Guillain-Barre Syndrome in a Case of Typhoid Fever: an Uncommon Association

2021 ◽  
Vol 32 (2) ◽  
pp. 142-144
Author(s):  
Abdul Basit Ibne Momen ◽  
Furial Quraishi Twinkle ◽  
Aminur Rahman ◽  
Firoz Ahmed Quraishi
Keyword(s):  
Case Report ◽  
Blood Culture ◽  
Typhoid Fever ◽  
Intravenous Immunoglobulin ◽  
Case Reports ◽  
Neurological Complication ◽  
Guillain Barre Syndrome ◽  
Intravenous Antibiotics ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Guillain-Barre syndrome (GBS) following typhoid is extremely uncommon and only few case reports are available in literature. The importance of this case report is to highlight upon the fact that a diagnosis of GBS should always be kept in mind whenever a patient of typhoid fever develops weakness. We report a young girl with blood culture proven typhoid fever that developed this very rare neurological complication quite early in the course of the disease. Following treatment with intravenous antibiotics and intravenous immunoglobulin, she was improved. Bangladesh J Medicine July 2021; 32(2) : 142-144

scholarly journals Zika Virus and the Guillain–Barré Syndrome — Case Series from Seven Countries

2016 ◽  
Vol 375 (16) ◽  
pp. 1598-1601 ◽  
Author(s):  
Thais dos Santos ◽  
Angel Rodriguez ◽  
Maria Almiron ◽  
Antonio Sanhueza ◽  
Pilar Ramon ◽  
...  
Keyword(s):  
Zika Virus ◽  
Case Series ◽  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré
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