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Guillain-Barré Syndrome as a Complication of COVID-19
Adeel S Zubair1, Aarij S Zubair2, Kunal Desai1
1Neurology, Yale University, New Haven, USA.
Insights
Two unusual cases of Guillain-Barre syndrome (GBS) occurred eight weeks after COVID-19 infection. Prompt diagnosis and treatment with intravenous immunoglobulin therapy were effective for these neurological complications.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Coronavirus disease 2019 (COVID-19) can cause various neurological complications.
- Guillain-Barre syndrome (GBS) is a rare neurological complication associated with infections, including COVID-19.
Observation:
- Two cases of GBS developed approximately eight weeks after initial COVID-19 infection.
- This delayed onset is unusual for post-infectious GBS.
- Diagnosing GBS in critically ill COVID-19 patients with prolonged hospital stays presents diagnostic challenges.
Findings:
- Clinical suspicion, electrodiagnostic studies (nerve conduction studies and electromyography), and cerebrospinal fluid analysis are crucial for diagnosing GBS.
- Both patients demonstrated a positive response to intravenous immunoglobulin therapy.
Implications:
- The findings highlight the possibility of a delayed GBS onset following COVID-19.
- Early and accurate diagnosis is essential for effective management of GBS in the context of COVID-19.
- Intravenous immunoglobulin therapy is a viable treatment option for GBS associated with COVID-19.
Abstract:
Coronavirus disease 2019 (COVID-19) is associated with multiple neurological complications including Guillain-Barre syndrome (GBS). While there are reports of COVID-19 -related GBS cases, much remain unknown. We report two cases of GBS-associated COVID-19, which started about eight weeks after the initial COVID-19 infection. Such a long duration between infection and symptom onset of GBS is unusual for post-infectious GBS. Moreover, severely ill patients with COVID-19 may have prolonged hospital stay leading to critical illness myoneuropathy. Diagnosing superimposed GBS can be challenging in such cases. Clinical suspicion, nerve conduction studies with electromyography, and cerebrospinal fluid analysis can help in making the correct diagnosis. Both presented cases responded to intravenous immunoglobulin therapy.
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