A 35-year-old young patient with acute idiopathic polyneuritis (Guillain-Barré syndrome): a case report (original) (raw)
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Guillain-Barre Syndrome: A Case Report
Journal of Tropical Pharmacy and Chemistry
Guillain-Barre syndrome (GBS) is a complicated degenerative neurological disorder which can be acute or chronic in nature. It is an acquired condition which is characterized by progressive, symmetrical, proximal and distal tingling and weakness. Muscle stretch reflexes are decreased to absent and loss of sensation is common. Etiology remains unclear but pathophysiology includes demyelination of spinal nerve roots. Death is rare. Early diagnosis and prompt referral should occur in severe cases due to the incidence of potential ventilation failure and cardiovascular instability in some patients. The case of a 26-year-old male presenting to a physician is described. The importance of a correct diagnosis by the physician and the subsequent management is reviewed. Key words: Guillain-Barre syndrome, extremity weakness, peripheral nerves, trauma
Case Report on Guillain Barre Syndrome: Acute Inflammatory Demyelinating Polyneuropathy
https://www.ijrrjournal.com/IJRR\_Vol.8\_Issue.9\_Sep2021/IJRR-Abstract069.html, 2021
Guillain Barre Syndrome (GBS) is an autoimmune disorder which affects the peripheral nervous system. It is a rare disorder affects in 1 per million people in year. It is characterized by symmetrical, progressive limb weakness and tingling. Case Report: A 53 year old male patient was presented with insidious onset of difficulty in moving right upper and lower limbs as well as gradual weakness of left limbs, and breathing difficulty, known case of diabetics' mellitus and hypertension. Nerve conduction study shows suggest axonopathy; Acute Inflammatory Demyelinating Polyneuropathy (AIDP) is identified, which is a subtype of Guillain Barre Syndrome. Patient gradually develops areflexia, bifacial weakness, and quadriparesis. Patient was treated with IV immunoglobulin and intranasal oxygen therapy. Patient shows slight improvement in his medical condition, shows improvement in the power of lower limbs after one week of therapy. Physiotherapy was suggested.
Guillain- Barre Syndrome: A Rare Immune Mediated Polyneuropathy
Indian Journal of Pharmacy Practice, 2017
Guillain-Barré Syndrome (GBS) is a rare autoimmune disorder associated with demyelinating polyneuropathy requiring early diagnosis and accurate treatment. From birth to 30 years, the annual incidence is fairly uniform at 1.3 to 1.9 per 100,000. Clinical hallmarks include symmetrical flaccid muscle paresis and areflexia in the presence of an increased cerebrospinal fluid protein and electrophysiologic studies demonstrating demyelination. A case of 29 year old female presenting to a tertiary care hospital with GB syndrome and hypothyroidism is described. The significance of an appropriate diagnosis by the physician and subsequent management by the clinical staff is reviewed.
Guillain-Barre Syndrome and its Variants: Clinical Course and Prognostic Factors
Noro Psikiyatri Arsivi, 2017
Introduction: We aimed to analyze the frequency, clinical characteristics, medical treatment options and final functional status of Guillain-Barré syndrome (GBS) and its variants in a population from a tertiary hospital setting. Methods: All medical records of patients with acute inflammatory polyneuropathy between the years of 1998-2013 were retrospectively screened. Demographic, clinical and laboratory information, treatment options and the rate of recovery of the patients were gathered. Results: A total of 183 patients met the study criteria. Subtypes were typical demyelinating form (n=102, 79.1%), acute motor sensory axonal variant (n=11, 8.5%), acute motor axonal variant (n=10, 7.8%), Miller-Fisher syndrome (n=5, 3.9%), and pure sensory subtype (n=1, 0.8%). Remaining patients had the diagnosis of acute-onset chronic inflammatory demyelinating polynuropathy. The data of treatment option were available for 70 patients. Most of the patients received intravenous immunoglobulin (IVIg) treatment or the combination of IVIg and methylprednisolone. One patient died, there was no improvement in eight patients and rest showed improvement with varying degrees. Conclusions: We did not observe major change of recovery between different treatment options, however, most of the patients using methylprednisolone required IVIg because of inadequate response.
Guillain Barre Syndrome: A Retrospective Study of Ten Years
Purpose: Guillain-Barre Sydrome(GBS) is one of the reasons of acute polyneuropathy causing severe morbidity and mortality. Twenty nine patients with GBS were included in our study. Clinical, laboratory, electrophysiological and prognostic features of the patients were evaluated retrospectively. Method: Twenty-nine patients with GBS according to Asburys criteria were retrospectively evaluated for about ten years from 1993 to 2002. The patients were clinically classified according to the criteria of Hughes and Italian GBS study group. Patients were divided in to four groups due to their electrophysiological evaluation: acute inflammatory demyelinating polyneuropathy (AIDP), axonal forms (AMAN, AMSAN), Miller Fishers Syndrome (MFS) and unclassified. All patients were evaluated for age, gender, type of GBS, antecedent events, initial symptoms, CSF features, treatment, scores of GBS and complications. Findings: AIDP were found in 45% of patients, axonal form in 34.5%, MFS in 3.5% and u...
BIRDEM Medical Journal, 2017
Background: Guillain-Barré syndrome (GBS) is the commonest cause of acute flaccid paralysis worldwide, with an incidence of 0.6-4 per 100.000 inhabitants per year. It affects all age groups and carries an incapacity burden of up to 20%. The aims of this study were to evaluate the demographic and clinical presentation, hospital care and outcome with different modalities of treatment in adult patients suffering from GBSadmittedina tertiary care hospital in Dhaka. Methods: This observational study was done in the Neurology department of a tertiary care hospital in Dhaka.The studystarted in July-2011 and the first fiftypatients suffering from GBSwereenrolledconsecutively. Subjects included in this study were>18years of age.All the patients were interviewed and clinically examined. Relevant data were documented in a structured questionnaire. Nerve conduction Study (NCS) and Cerebrospinal fluid (CSF) study results were also documented. All of patients were watched for respiratory insufficiency and those who developed respiratory paralysis were transferred to ICU for respiratory assistance. According to clinical and electrophysiological criteria, the patients were classified into different variants of GBS. Patients were treated with intravenous immunoglobulin (IVIg), plasmapheresis, supportive care and outcome was observed. The patient who recovered and were discharged were later followed up on out-patientbasis for one month. Results: The commonest age group affected was 31-50 yrs with male preponderance .The mean age of study subjects was 46years. In most of the patient their weakness progressed for 3-5 days. Clinical evidence of a preceding infection was present inforty-six percent of the patientsbutcausative organism was not identified.Clinical presentations were quadriparesis in 84 % of patients, cranial nerve palsy in 48% of patients. Severe respiratory involvement requiring mechanical ventilation developed in 10% of patientsafter admission. CSF study was done and only10 subjects displayed typical findings of albumino cytological dissociation. NCS wasabnormal in all study subjects and revealed Acute Motor Sensory Axonal Neuropathy (AMSAN) in58%of study population. Among the fifty patients 23received plasmapheresis and another 9 receivedstandard IVIg therapy. Of these patients 20(88%) and 7 (77.6%) patients made significant recovery, respectively. Residual neurodeficit persisted in 6 of the remaining patients who received treatment in the form of only physiotherapy at the end of one month follow-up. Conclusion: Rapidly progressive quadriparesis with cranial nerve involvement was the commonest presentation. In this group of patients NCS proved to be a sensitive study for early diagnosis of patients with GBS in both diabetic and non-diabetic population. The axonal variety of GBS was more common than the demyelinating type. Although not statistically significant, the better response to plasmapheresis seemedencouraging. Again the patients who received IVIg or plasmapheresis early in the course of disease had faster recovery as compared to patients who received only supportive line of treatment.
A Case Study on Guillain-Barre Syndrome with Peripheral Sensorimotor Neuropathy
https://www.ijrrjournal.com/IJRR\_Vol.6\_Issue.11\_Nov2019/Abstract\_IJRR0068.html, 2019
Guillain-Barre Syndrome (GBS) can be described as the collection of clinical syndromes that includes acute inflammatory polyradiculoneuropathy with diminished reflexes and resultant weakness. A 25 year old male patient suddenly started a feeling of numbness of bilateral hands and sole followed by sudden onset of weakness of bilateral lower limb with difficulty in arising from floor and slowness of walking. On subsequent days the weakness was progressed to both lower and upper extremities and on clinical examination it was found that, distal sensory loss was present, bilateral hip of right was greater(grade 2) than left hip (grade 3).Muscle stretch reflex were absent. On neurological examination, the patient was alert, oriented and intact speech and memory, pupils equally react and cranial nerve was intact. All the laboratory parameters were normal but an elevated protein level of 2.05g/L with increased IgG fraction (25%). Nerve conduction study (NCS) were performed and all 4 limbs showed demyelinating motor sensory polyradiculoneuropathy. Sensory nerve action potentials (SNAP) amplitudes and sensory nerve conduction velocity(SNCV) of both upper and lower limb extremities revealed borderline prolonged distal latencies. Evoked amplitude of compound muscle action potentials (CMAPs) were of reduced amplitude and temporally dispersed reduced conduction velocity, prolonged or absent F-waves reflect proximal spinal roots and distal motor terminals. The patient received a 5-day course of IV immunoglobulins and underwent physiotherapy, speech and language therapy. GBS dependent upon early diagnosis and intervention may be important in the long term prognosis. Medical care for GBS patient is considered crucial for health care team.
Clinical profile of Guillian Barre Syndrome (GBS) in a tertiary care hospital of GMC Srinagar
International Journal of Medical Science and Innovative Research (IJMSIR), 2019
Background: This study was done in SMHS hospital of Government Medical College Srinagar over a period of 2 years.Different clinical presentation of GBS were noted and correlation between clinical features and outcome at discharge was analysed.Various poor prognostic factors were noted in these patients. Conclusion: Varied presentation of GBS was noted in the study and newer variants like Ataxic and CCPD were observed. Patients with bulbar dysfunction, axonal variant of GBS and Autonomic dysfunction had poor outcome. Indication for mechanical ventilation had adverse effect on outcome. Methods: 50 patients admitted in medical wards were included in the study based on diagnostic criteria modified by ASBURY. Detailed history and examination was done and necessary lab investigations including CSF and electrophysiological study were done. Results: Out of 50 patients,20 patients had classical AIDP presentation.10 patients had paraparetic variant of GBS.7 patients needed ventilator support in view of bulbar dysfunction.4 patients were Miller fischer variant.4 patients had polyneuritis cranalis and 2 pts had Ataxic variant.3 had Combined central and peripheral demylination syndrome (CCPD) The factors responsible for poor outcome at discharge were a. Need for mechanical ventilation. b. Axonal variant GBS on EPS c. Markedly reduced CMAP d. Bulbar involvement e. Autonomic dysfunction Conclusion: Varied presentation of GBS was noted in the study and newer variants like Ataxic and CCPD were observed. Patients with bulbar dysfunction, axonal variant of GBS and Autonomic dysfunction had poor outcome.Indication for mechanical ventilation had adverse effect on outcome. Keywords: GBS = Guillain Barre Syndrome, EPS= Electrophysiological Studies, AV = Ataxic Varient, CCPD = Combined Central & Peripheral Demyelination
Guillain-Barré Syndrome With a Peculiar Course: A Case Report
Cureus, 2021
Guillain-Barré syndrome (GBS) or acute inflammatory demyelinating polyradiculoneuropathy (AIDP) is a rare autoimmune disorder in which the body's immune system mistakenly attacks the nerves. In this report, we present a case of a 15-month-old girl who presented with an inability to walk and support the vertical and sitting positions, pain in the lower limbs accompanied by grimaces, muscular weakness, and agitation due to gait disturbances. This is a unique case in that GBS affected a previously healthy girl and was associated with pneumonia and anemia as the disease progressed, causing an intriguing diagnosis. Also, another remarkable aspect of our case is that complete recovery was achieved following intravenous immunoglobulin (IVIG) and anti-inflammatory treatment; our patient was able to walk again after receiving the first dose of IVIG.
A patient with Guillain-Barré syndrome and late recovery after 1 year
Journal of Musculoskeletal & Neuronal Interactions, 2019
A 39 year old male, presented to our department with rapid onset flaccid paralysis (upper extremity muscle weakness that was followed by lower extremity paralysis within hours). No sensory disturbances, respiratory failure or cardiovascular dysfunction was noted. 9 days before admission, the patient reported high fever with acute non bloody diarrhea. Past medical history was negative for comorbidities. Motor strength upon presentation was more severely affected in lower than upper extremities: deltoid/ elbow strength 3/5, wrist strength 1/5, hand strength 1/5 (extension) and 2/5 (flexion), iliopsoas 1/5, maximus gluteus 1/5, quadriceps 1/5, foot dorsiflexion/ plantarflexion 1/5. Electroconductive studies along with cerebrospinal fluid paracentesis were performed; the laboratory tests along with the clinical presentation led to the diagnosis of postgastroenteritis Guillain-Barré syndrome (GBS). Since the patient was nonambulatory within 4 weeks of symptoms presentation, treatment wit...