Case Report: Guillain-Barré Syndrome Associated With COVID-19. 2021

Eman M Khedr, and Ahmed Shoyb, and Khaled O Mohamed, and Ahmed A Karim, and Mostafa Saber
Department of Neurology and Psychiatry, Assiut University, Asyut, Egypt.

Guillain-Barré syndrome (GBS) is a potentially fatal, immune-mediated disease of the peripheral nervous system that is usually triggered by infection. Only a small number of cases of GBS associated with COVID-19 infection have been published. We report here five patients with GBS admitted to the Neurology, Psychiatry, and Neurosurgery Hospital, Assiut University/Egypt from July 1 to November 20, 2020. Three of the five patients were positive for SARS-CoV-2 following polymerase chain reaction (PCR) of nasopharyngeal swabs on day of admission and another one had a high level of IgM and IgG; all had bilateral ground-glass opacities with consolidation on CT chest scan (GGO) and lymphopenia. All patients presented with two or more of the following: fever, cough, malaise, vomiting, and diarrhea with variable duration. However, there were some peculiarities in the clinical presentation. First, there were only 3 to 14 days between the onset of COVID-19 symptoms and the first symptoms of GBS, which developed into flaccid areflexic quadriplegia with glove and stocking hypoesthesia. The second peculiarity was that three of the cases had cranial nerve involvement, suggesting that there may be a high incidence of cranial involvement in SARS-CoV-2-associated GBS. Other peculiarities occurred. Case 2 presented with a cerebellar hemorrhage before symptoms of COVID-19 and had a cardiac attack with elevated cardiac enzymes following onset of GBS symptoms. Case 5 was also unusual in that the onset began with bilateral facial palsy, which preceded the sensory and motor manifestations of GBS (descending course). Neurophysiological studies showed evidence of sensorimotor demyelinating polyradiculoneuropathy, suggesting acute inflammatory polyneuropathy (AIDP) in all patients. Three patients received plasmapheresis. All of them had either full recovery or partial recovery. Possible pathophysiological links between GBS and COVID-19 are discussed.

UI MeSH Term Description Entries

Related Publications

Eman M Khedr, and Ahmed Shoyb, and Khaled O Mohamed, and Ahmed A Karim, and Mostafa Saber
October 2021, Journal of neurovirology,
Eman M Khedr, and Ahmed Shoyb, and Khaled O Mohamed, and Ahmed A Karim, and Mostafa Saber
June 2020, Journal of clinical neuromuscular disease,
Eman M Khedr, and Ahmed Shoyb, and Khaled O Mohamed, and Ahmed A Karim, and Mostafa Saber
April 2021, Neurology. Clinical practice,
Eman M Khedr, and Ahmed Shoyb, and Khaled O Mohamed, and Ahmed A Karim, and Mostafa Saber
January 2020, Journal of investigative medicine high impact case reports,
Eman M Khedr, and Ahmed Shoyb, and Khaled O Mohamed, and Ahmed A Karim, and Mostafa Saber
April 2022, Rinsho shinkeigaku = Clinical neurology,
Eman M Khedr, and Ahmed Shoyb, and Khaled O Mohamed, and Ahmed A Karim, and Mostafa Saber
May 2022, Emerging infectious diseases,
Eman M Khedr, and Ahmed Shoyb, and Khaled O Mohamed, and Ahmed A Karim, and Mostafa Saber
January 2020, The Pan African medical journal,
Eman M Khedr, and Ahmed Shoyb, and Khaled O Mohamed, and Ahmed A Karim, and Mostafa Saber
December 2021, Emerging infectious diseases,
Eman M Khedr, and Ahmed Shoyb, and Khaled O Mohamed, and Ahmed A Karim, and Mostafa Saber
September 2020, BMJ case reports,
Eman M Khedr, and Ahmed Shoyb, and Khaled O Mohamed, and Ahmed A Karim, and Mostafa Saber
January 2023, Frontiers in neurology,
Copied contents to your clipboard!