scholarly journals Treatment-related fluctuation in Guillain-Barre syndrome

2011 ◽  
Vol 02 (02) ◽  
pp. 168-170 ◽  
Author(s):  
Thirunavukkarasu Thivakaran ◽  
Ranjanie Gamage ◽  
Inuka Kishara Gooneratne
Keyword(s):  
Immune Activation ◽  
Early Treatment ◽  
Disease Onset ◽  
Immunoglobulin Therapy ◽  
Chronic Inflammatory Demyelinating Polyradiculoneuropathy ◽  
Guillain Barre Syndrome ◽  
Disability Scale ◽  
Guillain Barré Syndrome ◽  
Immunoglobulin Treatment ◽  
Guillain Barré

ABSTRACTGuillain-Barre syndrome (GBS) is usually a monophasic illness but relapses occur. A 55-year-old female with hypertension and vitiligo presented with acute inflammatory demyelinating polyradiculoneuropathy. She improved with immunoglobulin treatment started on day 6 of illness, but relapsed on day 14 warranting repeat immunoglobulin therapy. Thereafter recovery was complete. Her relapse was due to treatment-related fluctuation (TRF). TRF is improvement in the GBS disability scale of at least one grade after completion of immunotherapy followed by worsening of the disability scale of at least one grade within the first 2 months after disease onset. Recurrent GBS and chronic inflammatory demyelinating polyradiculoneuropathy were excluded. During the peak of the illness ANA titres were transiently high. The presence of other medical conditions, predominant proximal weakness and the absence of preceding diarrhea are predictors for TRF seen in this patient. Early treatment and evidence of ongoing immune activation have contributed toward TRF.

Functional outcomes following inpatient rehabilitation of guillain-barré syndrome patients: Intravenous immunoglobulins versus plasma exchange

2021 ◽  
pp. 1-9
Author(s):  
Moshe Bondi ◽  
Einat Engel-Haber ◽  
Julie Wolff ◽  
Liza Grosman-Rimon ◽  
Ayala Bloch ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Plasma Exchange ◽  
Functional Outcomes ◽  
Daily Living ◽  
Functional Independence ◽  
Assessment Tools ◽  
Guillain Barre Syndrome ◽  
Disability Scale ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

BACKGROUND: Treatment with either Intravenous immunoglobulin (IVIg) or plasma exchange (PE) in patients with Guillain-Barré Syndrome (GBS) showed equivalent efficacy as attested by a commonly used disability scale. However, it has been suggested that this scale may not be sensitive enough to detect subtle functional changes between the two treatments since it mainly focuses on walking capability and respiratory function. OBJECTIVE: To evaluate functional outcomes following treatment with IVIg or PE using comprehensive scales that incorporate parameters of basic activities of daily living. METHODS: A retrospective cohort study was conducted between 2007 and 2013 in an inpatient neurologic rehabilitation department. The study group included 70 individuals with GBS: 39 were treated with PE and 31 with IVIg. A comparison of functional outcomes was performed using Functional Independence Measure (FIM), rehabilitation efficiency (REy), rehabilitation effectiveness (REs), and the GBS disability scale (GDS). RESULTS: Both treatments had a comparable effect on the various functional outcomes. Patients showed a significant increase in total FIM scores (30 points on average) during rehabilitation mainly as a result of an increase in motor sub-scores. A mean improvement of 1.23 (SD 0.9) in GDS was also observed. On average, individuals with GBS spent 20 days combined in the acute departments and 61 days in the rehabilitation department, with length of stay being similar for both treatments. CONCLUSIONS: IVIg and PE treatments have similar basic activities of daily living (ADL) functional outcomes. Nevertheless, due to the different mechanism of actions of these treatments and the multitude of GBS variants, it is possible that further comprehensive assessment tools may demonstrate differences in activity and participation of individuals with GBS.

Does intravenous immunoglobulin therapy in Guillain-Barré syndrome patients interfere with serological Zika detection?

2019 ◽  
Vol 18 (6) ◽  
pp. 632-633
Author(s):  
Anupama Karnam ◽  
Emmanuel Stephen-Victor ◽  
Mrinmoy Das ◽  
Laurent Magy ◽  
Jean-Michel Vallat ◽  
...  
Keyword(s):  
Intravenous Immunoglobulin ◽  
Immunoglobulin Therapy ◽  
Guillain Barre Syndrome ◽  
Intravenous Immunoglobulin Therapy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Guillain–Barré syndrome with associated thrombocytopenia: prompt response to combined corticosteroid and immunoglobulin treatment

1998 ◽  
Vol 8 (1) ◽  
pp. 50-52 ◽  
Author(s):  
Ulisse Corbanese ◽  
Andrea Martinuzzi ◽  
Clemente Possamai ◽  
Giancarlo Romeo ◽  
Giulio Possamai ◽  
...  
Keyword(s):  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
Immunoglobulin Treatment ◽  
Guillain Barré ◽  
Prompt Response

Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Pregnancy

2018 ◽  
Author(s):  
Pariwat Thaisetthawatkul ◽  
Eric Logigian
Keyword(s):  
Fetal Outcome ◽  
Chronic Inflammatory Demyelinating Polyradiculoneuropathy ◽  
Guillain Barre Syndrome ◽  
Progressive Muscle Weakness ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Viral Illness ◽  
Life Threatening ◽  
Depolarizing Agents ◽  
Guillain Barré

Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are both immune-mediated diseases of the peripheral nervous system that typically present with symmetric, progressive muscle weakness, areflexia, and sensory symptoms or signs. GBS evolves rapidly with a nadir at 2–4 weeks usually with an antecedent viral illness, while CIDP progresses more slowly over months to years. GBS is sometimes complicated by life-threatening respiratory failure or dysautonomia. Onset of GBS and relapse of CIDP can occur during pregnancy or postpartum. But with appropriate supportive care and immunotherapy, maternal and fetal outcome in both conditions is typically excellent. The exception is fetal outcome in GBS triggered by maternal CMV or Zika infection transmitted to the fetus. Full-term vaginal delivery and regional anesthesia are preferred in maternal GBS and CIDP, but if C-section and general anesthesia are indicated, non-depolarizing agents such as succinylcholine should be avoided.

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.

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