COVID-19 as a Trigger of Recurrent Guillain-Barré Syndrome

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Guillain-Barré syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system.
• While GBS can be triggered by infections, recurrent GBS (rGBS) is uncommon.
• COVID-19 has been an identified trigger for GBS.

Observation:

• A patient with a history of two prior GBS episodes, each following a viral infection, developed a third GBS episode.
• This recurrent GBS episode was precipitated by a SARS-CoV-2 (COVID-19) infection.
• The patient had achieved complete recovery from previous episodes, with only intermittent paresthesias remaining.

Findings:

• This case presents a rare instance of recurrent GBS secondary to COVID-19 infection.
• The study discusses the nosological classification of this event within the spectrum of rGBS and Chronic Inflammatory Demyelinating Polyneuropathy (CIDP).
• Differences in natural history, prognosis, and treatment strategies between rGBS and CIDP are considered.

Implications:

• Patients with a history of inflammatory demyelinating polyradiculoneuropathies are at risk for GBS recurrence following COVID-19.
• Close observation for new or worsening neurological symptoms is recommended for these patients after COVID-19 infection.
• Understanding the triggers and patterns of rGBS is crucial for accurate diagnosis and management.