A 50-Year-Old Patient with Guillain–Barré Syndrome after COVID-19: A Case Report

Severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, causes acute respiratory disease (coronavirus disease 2019; COVID-19). However, the involvement of other mechanisms is also possible, and neurological complications are being diagnosed more frequently. Here, we would like to present a case of a Polish patient with Guillain–Barré syndrome (GBS), after a documented history of COVID-19: A 50-year-old man, 18 days after the onset of COVID-19 symptoms, had progressive quadriparesis preceded by 1-day sensory disturbances. Based on the clinical picture, the results of diagnostic work-up including a nerve conduction study (ENG) that revealed a demyelinating and axonal sensorimotor polyneuropathy, and cerebrospinal fluid (CSF) analysis that showed albumin–cytological dissociation, an acute inflammatory demyelinating polyneuropathy was confirmed, consistent with GBS. Upon a therapeutic plasma exchange (TPE), the patient’s condition improved. The presented case of GBS in a patient after mild COVID-19 is the first case in Poland that has supplemented those already described in the global literature. Attention should be drawn to the possibility of GBS occurring after SARS-CoV-2 infection, even when it has a mild course.

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Guillain-Barre Syndrome following COVID-19 Infection: First Case Report from Kuwait and Review of the Literature

Dubai Medical Journal ◽

10.1159/000513382 ◽

2021 ◽

pp. 1-5

Author(s):

Walaa A. Kamel ◽

Ismail Ibrahim Ismail ◽

Jasem Yousef Al-Hashel

Keyword(s):

Intravenous Immunoglobulins ◽

Lower Limbs ◽

Guillain Barre Syndrome ◽

Global Pandemic ◽

First Case ◽

Immune Mediated ◽

Guillain Barré Syndrome ◽

Electrophysiological Studies ◽

History Of ◽

Guillain Barré

Objective: Guillain-Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy that is often related to a previous infectious exposure. GBS emerged as a potentially serious complication of coronavirus disease 2019 (COVID-19) since its declaration as a global pandemic. We report the first case from Kuwait, to the best of our knowledge. Clinical Presentation: A 72-year-old male presented with 3 weeks history of acute progressive and ascending lower limbs weakness. He developed these symptoms 3 weeks after testing positive to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Electrophysiological studies showed acute demyelinating polyradiculoneuropathy and cerebrospinal fluid showed protein-cell dissociation. He was successfully treated with intravenous immunoglobulins (IVIGs). Conclusion: Neurologists should be aware of GBS as a potentially serious complication associated with COVID-19. Our patient had a favorable outcome with IVIG with no autonomic or respiratory affection.

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A Rare Complication of Bariatric Surgery; Guillain Barre Syndrome

Journal of Clinical Images ◽

10.33582/2690-8662/1051 ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Mehlika Panpalli Ates ◽

◽

Dilara Mermi Dibek ◽

Hayat Guven ◽

Selim Selcuk Comoglu ◽

...

Keyword(s):

Bariatric Surgery ◽

Rare Complication ◽

Treatment Method ◽

Neurological Complications ◽

Guillain Barre Syndrome ◽

Obesity Prevalence ◽

Laboratory Findings ◽

Guillain Barré Syndrome ◽

Sensory Disturbances ◽

Guillain Barré

Objectives: Guillain-Barre Syndrome (GBS) is an acute, immune-mediated polyradiculoneuropathy characterized by rapidly progressive paresis and sensory disturbances. Laparoscopic Sleeve Gastrectomy (LSG), used of morbid obesity, is the standard surgical treatment method for Bariatric Surgery (BS). Neurological complications of BS are also increasing with growing obesity prevalence. We present a case of developed acute polyneuropathy after BS. Study Design-Methods: The presentation of GBS is ascending paralysis, reduction/loss of muscle stretch reflexes, and albumino-cytologic dissociation in the CSF. The diagnosis was made using anamnesis, neurological examination, Electroneuromyography (ENMG) and laboratory findings. Results: Neurological complications of BS are usually related to micronutrients deficiencies secondary to malabsorbtion after surgery. The complications are seen variable which are count encephalopathy, optic neuropathy, myelopathy, polyradiculoneuropathy, and polyneuropathy. Conclusions: Among these, GBS appears to be a very rare complication in BS. It is important to consider the diagnosis of peripheral neuropathy, and discrimination of GuillainBarré syndrome. Because of, their treatments are different.

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A concomitant Guillain-Barre Syndrome with COVID-19: a first case-report in Colombia

10.21203/rs.3.rs-61279/v1 ◽

2020 ◽

Author(s):

Nuvia Mackenzie ◽

Eva Lopez-Coronel ◽

Alberto Dau ◽

Dieb Maloof ◽

Salvador Mattar ◽

...

Keyword(s):

Diagnostic Testing ◽

Lower Limbs ◽

Guillain Barre Syndrome ◽

Case Control Studies ◽

First Case ◽

General Weakness ◽

Facial Diplegia ◽

Guillain Barré Syndrome ◽

History Of ◽

Guillain Barré

Abstract Background: During the COVID-19 pandemic, different neurological manifestations have been published. However, few cases of Guillain-Barre Syndrome and COVID-19 have been reported. We describe a concomitant Guillain-Barre Syndrome and COVID-19 patient.Case presentation: a 39 years old woman was admitted in a teaching hospital in Barranquilla, Colombia with a history of progressive general weakness with lower limb dominance. A previous symptom as ageusia, anosmia and intense headache was reported. On admission, facial diplegia, quadriparesis with lower limbs predominance and Medical Research Council Scale 2/5 in lower limbs and 4/5 in upper limbs was reported. During clinical evolution, due to general areflexia, hypertensive emergency and progressive diaphragmatic weakness, the patient was admitted to intensive care unit. Cerebrospinal Serum Fluid revealed protein-cytologic dissociation and electromyography test were compatible with Guillain-Barre Syndrome. By symptoms before hospitalization, SARS-CoV2 diagnostic testing was performed with positive result in second test. Management to COVID-19 and Guillain Barre Syndrome was performed and patient was discharged after 20 days of hospitalization with clinical improvement.Conclusions: Few cases have been published reporting COVID-19 and Guillain-Barre Syndrome. We report the first confirmed case of COVID-19 with concomitant Guillain-Barre Syndrome in Colombia. In patients with Guillain-Barre Syndrome, several viral and bacterial pathogens have been found in case-control studies but there are do not clarity in what triggers the immune-mediated destruction of nerves. More studies are needed to determine possible association among COVID-19 exposure and Guillain-Barre Syndrome.

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A Rare case of recurrent Guillain-Barré syndrome without albuminocytological dissociation

BMJ Case Reports ◽

10.1136/bcr-2018-226572 ◽

2018 ◽

pp. bcr-2018-226572

Author(s):

Anudeep Yelam ◽

Elanagan Nagarajan ◽

Raghav Govindarajan ◽

Pradeep C Bollu

Keyword(s):

Cerebrospinal Fluid ◽

Rare Case ◽

Guillain Barre Syndrome ◽

Csf Analysis ◽

Immune Mediated ◽

Guillain Barré Syndrome ◽

Sensory Disturbances ◽

Guillain Barré ◽

Csf Findings

Guillain-Barré syndrome (GBS) is an immune-mediated polyneuropathy, often preceded by an illness. It is a self-limiting illness in most of the cases, but recurrence is rare and can be seen in about 1%–6% of patients. GBS is characterised by progressive, symmetrical, proximal and distal weakness. Areflexia and sensory disturbances are also common. Patients with GBS usually have albuminocytological dissociation on cerebrospinal fluid (CSF) analysis. This is a case of a 69-year-old woman with recurrent GBS and normal CSF findings.

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History of Guillain-Barré syndrome

Clinical and Experimental Neuroimmunology ◽

10.1111/cen3.12339 ◽

2016 ◽

Vol 7 (4) ◽

pp. 305-311 ◽

Cited By ~ 3

Author(s):

Susumu Kusunoki

Keyword(s):

Guillain Barre Syndrome ◽

Guillain Barré Syndrome ◽

History Of ◽

Guillain Barré

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Guillain-Barré syndrome in patients with a recent history of Zika in Cúcuta, Colombia: A descriptive case series of 19 patients from December 2015 to March 2016

Journal of Critical Care ◽

10.1016/j.jcrc.2016.08.016 ◽

2017 ◽

Vol 37 ◽

pp. 19-23 ◽

Cited By ~ 50

Author(s):

Arturo Arias ◽

Lilian Torres-Tobar ◽

Gualberto Hernández ◽

Deyanira Paipilla ◽

Eduardo Palacios ◽

...

Keyword(s):

Case Series ◽

Guillain Barre Syndrome ◽

Recent History ◽

Guillain Barré Syndrome ◽

History Of ◽

Guillain Barré

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An Acute, Severe Axonal Sensorimotor Polyneuropathy in the Setting of Nitrous Oxide Abuse

The Neurohospitalist ◽

10.1177/1941874420910648 ◽

2020 ◽

Vol 10 (4) ◽

pp. 293-296

Author(s):

Jules C. Beal ◽

Yishan Cheng ◽

Sabiha Merchant ◽

Reza Zarnegar

Keyword(s):

Nitrous Oxide ◽

Vitamin B12 ◽

Clinical Picture ◽

Guillain Barre Syndrome ◽

Sensory Loss ◽

Laboratory Evaluation ◽

Sensorimotor Polyneuropathy ◽

Guillain Barré Syndrome ◽

B12 Deficiency ◽

Guillain Barré

Nitrous oxide, often used as an anesthetic agent, is also increasingly a drug of abuse due to its euphoric and anxiolytic effects. Frequent exposure to nitrous oxide can lead to neurologic complications, including B12 deficiency and resultant subacute myeloneuropathy, as well as direct neurotoxicity. A clinical presentation of acute sensorimotor polyneuropathy mimicking Guillain-Barré syndrome after chronic nitrous oxide abuse has been reported only rarely. Here we present a 17-year-old previously healthy girl presented with 10 days of progressive ascending sensory loss and weakness in the legs. She admitted to heavy nitrous oxide abuse over a period of a year or more. Laboratory evaluation was significant for normal vitamin B12 level with elevated homocysteine. A magnetic resonance imaging (MRI) of her spine showed abnormal signal involving the bilateral dorsal columns. Nerve conduction studies were suggestive of severe axonal sensorimotor polyneuropathy. This patient demonstrates concurrent multifactorial neurologic injury as a result of nitrous oxide abuse. She had a functional vitamin B12 deficiency as indicated by the elevated homocysteine, leading to a subacute combined degeneration that was evident on the MRI. In addition, she had evidence of direct neurotoxicity leading to axonal injury and sensorimotor polyneuropathy reminiscent of Guillain-Barré syndrome. This clinical picture is a serious but seldom reported possible complication if nitrous oxide abuse and should be considered in patients presenting with a clinical picture suspicious for Guillain-Barré syndrome or its variants.

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Rare variant of Guillain-Barré syndrome after chikungunya viral fever

BMJ Case Reports ◽

10.1136/bcr-2018-228845 ◽

2019 ◽

Vol 12 (4) ◽

pp. e228845 ◽

Cited By ~ 2

Author(s):

Sajid Hameed ◽

Sara Khan

Keyword(s):

Emergency Department ◽

Early Diagnosis ◽

Symptom Onset ◽

Complete Resolution ◽

Neurological Complications ◽

Acute Onset ◽

Guillain Barre Syndrome ◽

Ventilator Support ◽

Guillain Barré Syndrome ◽

Guillain Barré

Chikungunya (CHIK) viral fever is a self-limiting illness that presents with severe debilitating arthralgia, myalgia, fever and rash. Neurological complications are rare. We present a case of a 36-year-old woman who presented with acute onset progressive difficulty swallowing and left arm weakness. She was diagnosed with CHIK viral fever 4 weeks prior to admission. After investigations, she was diagnosed with a pharyngeal–cervical–brachial variant of Guillain-Barré syndrome. In hospital, she required ventilator support. Her condition improved after five sessions of intravenous immunoglobulin with almost complete resolution within 6 months of symptom onset. With frequent CHIK outbreaks, the neurological complications are increasingly seen in the emergency department. The knowledge of these associations will result in early diagnosis and treatment.

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Dysautonomia and hyponatraemia as harbingers of Guillain-Barre syndrome

BMJ Case Reports ◽

10.1136/bcr-2018-226925 ◽

2019 ◽

Vol 12 (4) ◽

pp. e226925 ◽

Cited By ~ 1

Author(s):

Preet Mukesh Shah ◽

Vijay Waman Dhakre ◽

Ramya Veerasuri ◽

Anand Bhabhor

Keyword(s):

Blood Pressure ◽

Secondary Hypertension ◽

Guillain Barre Syndrome ◽

Rare Presentation ◽

Normal Ranges ◽

Guillain Barré Syndrome ◽

History Of ◽

Autonomic Disturbances ◽

Guillain Barré ◽

Time Of Presentation

A 56-year-old woman with a medical history of hypertension presented to our hospital with back pain, abdominal pain, vomiting and elevated blood pressure. The laboratory parameters including evaluation for secondary hypertension were within normal ranges at the time of presentation. During her hospitalisation, fluctuations in her blood pressure and pulse were observed which were attributed to autonomic disturbances, the cause of which was unknown. On the seventh day after presentation to the hospital, the patient developed focal seizures and slurred speech which was believed to be secondary to hyponatraemia detected at that time. Hyponatraemia improved with hypertonic saline and she experienced no further seizures. On the eighth day of her admission, she developed acute flaccid paralysis of all her limbs and respiratory distress. We concluded this to be secondary to Guillain-Barre syndrome (GBS). She responded to plasmapheresis.The presence of dysautonomia and hyponatraemia before the onset of paralysis makes this a rare presentation of GBS.

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