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 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 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 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-Barre syndrome in patients with coronavirus disease-2019: Report of six cases and review of literature

2021 ◽  
Author(s):  
Ali Asghar Okhovat ◽  
Behnaz Ansari ◽  
Helia Hemasian ◽  
Bahram Haghi-Ashtiani ◽  
Soroor Advani ◽  
...  
Keyword(s):  
Case Reports ◽  
Epidemiological Studies ◽  
Guillain Barre Syndrome ◽  
Response To Treatment ◽  
First Episode ◽  
Review Of Literature ◽  
Axonal Polyneuropathy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Progressive Weakness

Background: Few studies have reported the association of Guillain-Barre syndrome (GBS) and coronavirus disease-2019 (COVID-19) infection. In this study, we reported GBS in six patients infected with COVID-19 and reviewed all existing literature about GBS in association with COVID-19. Methods: This study was performed in three referral centers of COVID-19 in Iran, and six patients with the diagnosis of GBS were enrolled. Patients enrolled in the study with acute progressive weakness according to the demyelinating or axonal variant of GBS, according to Uncini's criteria. Results: Four of our patients had axonal polyneuropathy, two patients had demyelinating polyneuropathy, and one patient required mechanical ventilation. All our patients had a favorable response to treatment. In one patient, the GBS symptoms recurred four months after the first episode. Conclusion: Limited case reports suggest a possible association between GBS and COVID-19. Such associations may be an incidental concurrence or a real cause-and-effect linkage; however, more patients with epidemiological studies are necessary to support a causal relationship.

scholarly journals Guillain-Barré Syndrome-Like Polyneuropathy Associated with Immune Checkpoint Inhibitors: A Systematic Review of 33 Cases

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Yan Li ◽  
Xiuchun Zhang ◽  
Chuansheng Zhao
Keyword(s):  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Case Reports ◽  
Guillain Barre Syndrome ◽  
Human Beings ◽  
Fisher Syndrome ◽  
Initial Symptoms ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Immune checkpoint inhibitors (ICIs) have been increasingly used in the treatment of various types of tumors with favorable results. But these treatments also led to a variety of immune-related adverse events (irAEs). Neurological irAEs such as Guillain-Barré Syndrome are rare and may have serious consequences once they occur. A systematic literature search was performed in PubMed and Embase for all case reports of GBS associated with ICIs published in English reporting on human beings from 1990 up to date. A total of 30 case reports ( total   patients = 33 ) were used for final analysis. The included cases were from 11 countries, covering 10 tumor types, with melanoma accounting for the largest number. The mean age was 62.2 ± 11.1 years old, and males were dominant (male: 26 and female: 7). The median time of initial symptoms was 8.2 weeks after the 1st dose of ICIs. The most common manifestations of GBS associated with ICIs were weakness, hyporeflexia or areflexia, and paresthesia in order. The GBS subtypes suggested by electrophysiological results were acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), and Miller Fisher syndrome (MFS). The protein level of CSF in patients with GBS related to ICIs was 180.68 ± 152.51  mg/dl. Immediate termination of ICIs followed by intravenous immunoglobulin was the preferred treatment option. 72.7% of patients recovered or had residual mild dysfunction after treatment. Elderly male patients with melanoma were most likely to develop ICI-related GBS. The specific neurological symptoms, CSF analysis, and electrophysiological examination were important means of diagnosis.

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

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