Guillain – Barré syndrome associated with SARS-CoV-2 infection

2021 ◽  
Author(s):  
E. I. Tsoma
Keyword(s):  
Cranial Nerves ◽  
Respiratory Muscles ◽  
Guillain Barre Syndrome ◽  
Haemophilus Influenzae Type ◽  
Barr Virus ◽  
Progressive Muscle Weakness ◽  
Fluid Analysis ◽  
Disturbance Of Consciousness ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Neurological manifestations of COVID‑19 infection are caused by its effects on CNS (headache, dizziness, disturbance of consciousness, convulsions, etc.) and PNS (anosmia, ageusia, visual impairment, radiculo‑ and neuropathy). Guillain – Barré syndrome (GBS) is a rare autoimmune disease associated with damage to the peripheral nervous system. 40 — 70 % of cases are associated with a previous infection: cytomegalovirus, Epstein–Barr virus, Haemophilus influenzae type b, Mycoplasma pneumoniae, Campylobacter jejuni etc. The clinical characteristics of this condition are progressive muscle weakness, reduction or loss of tendon reflexes (hyporeflexia and areflexia), paresthesias, paresis of the cranial nerves. The diagnosis is based on clinical data, cerebrospinal fluid analysis (protein level, cytosis, antigangliosid antibodies), as well as electroneuromyography. Most patients with Guillain – Barré syndrome totally recover. However, the most dangerous and severe complication of acute inflammatory demyelinating polyneuropathy is paralysis of the respiratory muscles. About a quarter of patients require urgent treatment at intensive care unit with mechanical ventilation and/or tracheostomy. Mortality in Guillain – Barré syndrome can reach to 10 %. There have been several reports of COVID‑19‑related GBS in the world scientific medical literature during the last year, but more information about this association and its implications is still missing. The aim of this report was to analyze the available information about cases of Guillain – Barré syndrome associated with COVID‑19 infection, to compare different variants of this condition and to share our own experience in clinical management of such patient.

scholarly journals Guillain-Barre Syndrome with Covid-19 Infection

2021 ◽  
Vol 10 (28) ◽  
pp. 2139-2141
Author(s):  
Savita Bansiram Pohekar ◽  
Amruta Shalikram Kothe
Keyword(s):  
Epstein Barr Virus ◽  
Guillain Barre Syndrome ◽  
Cerebrospinal Fluid Analysis ◽  
Barr Virus ◽  
Fluid Analysis ◽  
Breathing Disorders ◽  
Guillain Barré Syndrome ◽  
Epstein Barr ◽  
Guillain Barré ◽  
Muscle Reflexes

COVID-19 from Wuhan, China has spread easily all over the world. Most of the COVID-19 infected patients have fever and breathing disorders. Here, we report a case of Guillain-Barre syndrome (GBS) with a COVID-19 infection. GBS is a very rare disease with corona virus infection. It is really hard to diagnose. In this state the limbs of the patient are slowly weakened. The condition worsens daily with weakness of the limbs. The Guillain-Barre syndrome is a complex and acute or chronic neurological condition. Campylobacter jejuni and other viruses, including cytomegalovirus and Epstein Barr Virus, are causing this condition.1 It is a disorder that is progressive, symmetric, proximate, distal, and characterised by weakness. Muscle reflexes are reduced to absent. Aetiology is unclear, Death is uncommon. The diagnosis of GBS can be made by cerebrospinal fluid analysis and nerve conduction studies.2 We present a case of Guillain-Barre syndrome with COVID-19 infection, who presented to the emergency Outpatient department with complaints of weakness against his bilateral upper and lower limb.

scholarly journals Acute motor-sensory axonal polyneuropathy variant of Guillain–Barre syndrome complicating the recovery phase of coronavirus disease 2019 infection: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ahmed Maseh Haidary ◽  
Sarah Noor ◽  
Esmatullah Hamed ◽  
Tawab Baryali ◽  
Soma Rahmani ◽  
...  
Keyword(s):  
Recovery Phase ◽  
Sudden Onset ◽  
Therapeutic Interventions ◽  
Guillain Barre Syndrome ◽  
The Novel ◽  
Case Presentation ◽  
Progressive Muscle Weakness ◽  
Guillain Barré Syndrome ◽  
Novel Coronavirus ◽  
Guillain Barré

Abstract Introduction The novel coronavirus, since its first identification in China, in December 2019, has shown remarkable heterogeneity in its clinical behavior. It has affected humans on every continent. Clinically, it has affected every organ system. The outcome has also been variable, with most of the older patients showing grave outcomes as compared with the younger individuals. Here we present a rare and severe variant of Guillain–Barre syndrome that complicated the disease in recovery phase. Case presentation A 60-year-old Afghan man, who had been recovering from symptoms related to novel coronavirus associated disease, presented with sudden onset of progressive muscle weakness and oxygen desaturation. Electrophysiological workup confirmed the diagnosis of Guillain–Barre syndrome, and early institution of intravenous immunoglobulin resulted in complete resolution. Conclusion Guillain–Barre syndrome has recently been reported in many patients diagnosed with novel coronavirus associated disease. While clinical suspicion is mandatory to guide towards an effective diagnostic workup, early diagnosis of this complication and timely institution of therapeutic interventions are indispensable and lifesaving.

scholarly journals A Case of Acute Motor Sensory Axonal Neuropathy: A Variant of Guillain-Barré Syndrome, with Possible Syndrome of Irreversible Lithium-Effectuated Neurotoxicity

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
David Y. Liu ◽  
Jessica R. Hollenbach ◽  
Jason A. Gregorin ◽  
Jonathan H. Wynbrandt
Keyword(s):  
Prolonged Mechanical Ventilation ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Respiratory Compromise ◽  
Term Care ◽  
Fluid Analysis ◽  
Guillain Barré Syndrome ◽  
Immune Globulins ◽  
Prolonged Recovery ◽  
Guillain Barré

Acute Motor Sensory Axonal Neuropathy (AMSAN) is a rare and severe variant of Guillain-Barré syndrome (GBS) that has a prolonged recovery course. GBS is often suspected due to ascending muscle weakness, sensation difficulties, respiratory compromise, and antecedent diarrhea. The diagnosis of GBS is supported by cerebrospinal fluid analysis showing albuminocytologic dissociation. Electromyogram and nerve conduction study confirm the diagnosis and allow for further classification by variant. Treatment involves either IV immune globulins or plasmapheresis, and patients typically recover. However, depending on the variant and severity, patients may ultimately require prolonged mechanical ventilation with tracheostomy. In these cases, they may continue to have persistent muscle and sensation abnormalities requiring long-term care. We present a unique case of a 38-year-old female patient with decade-long use of lithium for bipolar disorder that presented with acute lithium toxicity. Though she was ultimately diagnosed with AMSAN, the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) may have also contributed to her persistent neurological sequelae.

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 Child with Guillain-Barré Syndrome Responding to Plasmapheresis: A Case Report

2020 ◽  
Vol 3 (1) ◽  
pp. 4-11
Author(s):  
Sarmad Al Hamdani ◽  
Fatema Yusuf Aljanabi ◽  
Maryam Isa Abdulrasool ◽  
Alaa Haitham Salman
Keyword(s):  
Axonal Neuropathy ◽  
Cranial Nerves ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Upper Limbs ◽  
Acute Motor Axonal Neuropathy ◽  
Guillain Barré Syndrome ◽  
Foley’S Catheter ◽  
Guillain Barré ◽  
First Session

Intravenous immunoglobulin (IVIG) has long been regarded as the first-line treatment for Guillain-Barré syndrome (GBS), with plasmapheresis only being reserved for severe cases or used as an additional therapy of unproven efficacy. Here, we present the case of a 9-year-old girl with acute motor axonal neuropathy (AMAN), a rapidly progressive subtype of GBS that caused her to fall into respiratory failure. The patient failed to show a response 10 days after starting IVIG, but showed rather quick improvement with plasmapheresis. She received a total of 5 sessions of plasmapheresis on alternate days over a course of 8 days. Before starting plasmapheresis, her muscle strength was 2/5 in both upper limbs and 1/5 in both lower limbs, and she was dependent on mechanical ventilation. Following the first session, her power improved from 2/5 to 4/5 in the upper limbs, and the gag and sucking reflexes were recovered. On day 3, after the second session was initiated, she was extubated successfully (having been on a ventilator for 2 weeks) and remained on continuous positive airway pressure for the next 48 h, after which she was on room air. In addition, she was having hypertension from the first day of the diagnosis (which was due to autonomic instability), which improved after clonidine to maintain her blood pressure. She was also initially having urinary retention, then was off Foley’s catheter. The patient was discharged from the hospital 2 weeks following the first session of plasmapheresis, with power grade 4/5 in both her upper and lower limbs. Her cranial nerves had recovered fully, and she was able to walk with aids.

scholarly journals Guillain-Barré Syndrome Masquerading As Cervical Myelopathy

2017 ◽  
Vol 5 (2) ◽  
pp. 129-131
Author(s):  
Uzzwal Kumar Mallick ◽  
Badrul Alam ◽  
Mohammad Asaduzzaman
Keyword(s):  
Intravenous Immunoglobulin ◽  
Cervical Myelopathy ◽  
Correct Diagnosis ◽  
Guillain Barre Syndrome ◽  
Ventilator Support ◽  
Fluid Analysis ◽  
Guillain Barré Syndrome ◽  
Electrophysiological Studies ◽  
Atypical Manifestations ◽  
Guillain Barré

Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy. In typical cases, the first symptoms of GBS are pain, numbness, paresthesia, weakness in the limbs. Autonomic involvement is common and causes urinary retention and ileus. Most of these symptoms overlap with those of cervical myelopathy. Therefore, correct diagnosis of GBS in a patient with symptomatic cervical myelopathy or in a patient with atypical manifestations of GBS can be difficult, especially early in the course of GBS. We report a 60-year-old man who was admitted to the neurosurgery department with worsening neck pain, numbness and weakness in the hands initially thought to be secondary to progressive cervical myelopathy. However, his symptoms rapidly progressed to flaccid areflexic quadriparesis and respiratory difficulty within few days and shifted to ICU for ventilator support. Electrophysiological studies and cerebrospinal fluid analysis were consistent with an acquired demyelinating polyradiculoneuropathy. We planned for immunotherapy with intravenous immunoglobulin , but his condition was improving day by day with conservative treatment , so immunotherapy with intravenous immunoglobulin was not initiated. Any patient presenting as unexplain Cervical myelopathy, GBS should be kept in mind before planning any surgical intervention.Bangladesh Crit Care J September 2017; 5(2): 129-131

EPSTEIN-BARR VIRUS AND GUILLAIN-BARRE SYNDROME

The Lancet ◽  
1972 ◽  
Vol 300 (7790) ◽  
pp. 1285-1287 ◽  
Author(s):  
Charles Grose ◽  
PaulM. Feorino
Keyword(s):  
Epstein Barr Virus ◽  
Guillain Barre Syndrome ◽  
Barr Virus ◽  
Guillain Barré Syndrome ◽  
Epstein Barr ◽  
Guillain Barré
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