scholarly journals Isolated Bilateral Ptosis as an Early Sign of Guillain-Barré Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Yahia Z. Imam ◽  
Dirk Deleu
Keyword(s):  
Intravenous Immunoglobulins ◽  
Young Female ◽  
Initial Presentation ◽  
Guillain Barre Syndrome ◽  
Bilateral Ptosis ◽  
Igg Antibody ◽  
Fisher Syndrome ◽  
Ocular Myasthenia ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Background. Guillain-Barré syndrome (GBS) has many variants with distinct presentations. Ptosis as an initial presentation is rare.Case Report. We describe a young female with bilateral ptosis without ophthalmoplegia as the initial presentation of Guillain-Barré ptosis in an anti-GQ1b IgG antibody negative patient with a favorable outcome to intravenous immunoglobulins.Objectives. Our paper highlights the importance of recognizing GBS as a potential etiology in a patient presenting with isolated ptosis, particularly since the course of GBS can be more dramatic than in the anti-GBQ1b syndromes such as ophthalmoparesis without ataxia and Miller Fisher syndrome or ocular myasthenia.Conclusion. This is the first paper of anti-GBQ1b antibody negative GBS presenting with isolated ptosis without ophthalmoparesis. GBS should be included in the list of differential diagnosis of such presentations.

scholarly journals Real-world treatment of adult patients with Guillain-Barré syndrome over the last two decades

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jakob Rath ◽  
Gudrun Zulehner ◽  
Bernadette Schober ◽  
Anna Grisold ◽  
Martin Krenn ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Real World ◽  
Intravenous Immunoglobulins ◽  
Guillain Barre Syndrome ◽  
Fisher Syndrome ◽  
Treatment Practice ◽  
Guillain Barré Syndrome ◽  
Multiple Treatments ◽  
Guillain Barré

AbstractThis study investigated treatment characteristics of Guillain-Barré syndrome (GBS) in a real-world setting between 2000 and 2019. We analyzed clinical improvement between nadir and last follow-up in patients with severe GBS (defined as having a GBS disability scale > 2 at nadir) and aimed to detect clinical factors associated with multiple treatments. We included 121 patients (74 male; median age 48 [IQR 35–60]) with sensorimotor (63%), pure motor (15%), pure sensory (10%) and localized GBS (6%) as well as Miller Fisher syndrome (6%). 44% of patients were severely affected. All but one patient received at least one immunomodulatory treatment with initially either intravenous immunoglobulins (88%), plasma exchange (10%) or corticosteroids (1%), and 25% of patients received more than one treatment. Severe GBS but not age, sex, GBS subtype or date of diagnosis was associated with higher odds to receive more than one treatment (OR 4.22; 95%CI 1.36–13.10; p = 0.01). Receiving multiple treatments had no adjusted effect (OR 1.30, 95%CI 0.31–5.40, p = 0.72) on clinical improvement between nadir and last follow-up in patients with severe GBS. This treatment practice did not change over the last 20 years.

scholarly journals An Overlapping Case of Miller Fisher Syndrome, Bickerstaff’s Encephalitis, and the ASMAN Variant of Guillain-Barre Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
E. J. Pegg ◽  
S. K. Chhetri ◽  
U. G. Lekwuwa ◽  
T. Majeed
Keyword(s):  
Axonal Neuropathy ◽  
Sensory Neuropathy ◽  
Miller Fisher Syndrome ◽  
Guillain Barre Syndrome ◽  
Igg Antibody ◽  
Limb Weakness ◽  
Fisher Syndrome ◽  
Bickerstaff’S Brainstem Encephalitis ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

A 56-year-old man presented with a 3-day history of progressive tingling of the hands, unsteadiness, and diplopia. He was initially diagnosed clinically with Miller Fisher Syndrome (MFS) but later developed limb weakness consistent with Guillain-Barre Syndrome (GBS) and subsequently reduced consciousness consistent with Bickerstaff’s brainstem encephalitis (BBE). Neurophysiology revealed an axonal motor and sensory neuropathy, in keeping with the Acute Motor and Sensory Axonal Neuropathy (AMSAN) variant of GBS. We believe that our patient had an MFS-AMSAN-BBE overlap syndrome. This is supported by his glycolipid antibody profile with high titres of anti-GQ1b IgG antibody and anti-GD1a IgG antibody. Anti-GQ1b antibodies are frequently found in both MFS and BBE and the anti-GD1a antibody is associated with axonal forms of GBS. Overlapping cases of MFS and BBE are well described, and because the same antibody is often found in both conditions, it is thought that they share a common autoimmune mechanism. BBE has also been previously reported in association with GBS lending support that it also lies on the same spectrum. This overlapping case of ASMAN variant of GBS, MFS, and BBE provides further support that these conditions are part of the same spectrum.

scholarly journals Rare Clinical Presentation in a Case of Pediatric Guillain-Barré Syndrome and Rehabilitation Outcome

2021 ◽  
Author(s):  
G. Sonachand Sharma ◽  
Anupam Gupta ◽  
Raghavendra K. ◽  
B.P. Navin ◽  
Meeka Khanna ◽  
...  
Keyword(s):  
Cranial Nerves ◽  
Inpatient Rehabilitation ◽  
Guillain Barre Syndrome ◽  
Cranial Nerve Involvement ◽  
Bilateral Ptosis ◽  
Rare Presentation ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Time Of Admission

AbstractNearly half of patients with Guillain-Barré syndrome (GBS) have cranial nerve involvement. Ocular muscle weakness or ophthalmoplegia occurs in ~10% of these patients. Patients presenting with bilateral ptosis, with or without ophthalmoplegia, is a rare finding. Anti-GQ1b antibody has been found in Miller Fisher syndrome and GBS with ophthalmoplegia variants. We report a case of GBS in a young boy presenting with rare presentation of tetraplegia, bilateral ptosis, and facial palsy, no ataxia but ophthalmoplegia with seronegative anti-GQ1b antibody. Patient showed recovery in cranial nerves involvement as well as with motor and functional recovery after 3 weeks of inpatient rehabilitation (Barthel Index score improved to 60/100 at the time of discharge from 20/100 at the time of admission). He was independent for most of the activity of daily livings including ambulation at the time of discharge from rehabilitation unit (p < 0.001).

scholarly journals Post-Infectious Guillain–Barré Syndrome Related to SARS-CoV-2 Infection: A Systematic Review

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 167
Author(s):  
Pasquale Sansone ◽  
Luca Gregorio Giaccari ◽  
Caterina Aurilio ◽  
Francesco Coppolino ◽  
Valentina Esposito ◽  
...  
Keyword(s):  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Guillain Barre Syndrome ◽  
Response To Treatment ◽  
Comprehensive Overview ◽  
Fisher Syndrome ◽  
Immunomodulating Therapy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Background. Guillain-Barré syndrome (GBS) is the most common cause of flaccid paralysis, with about 100,000 people developing the disorder every year worldwide. Recently, the incidence of GBS has increased during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemics. We reviewed the literature to give a comprehensive overview of the demographic characteristics, clinical features, diagnostic investigations, and outcome of SARS-CoV-2-related GBS patients. Methods. Embase, MEDLINE, Google Scholar, and Cochrane Central Trials Register were systematically searched on 24 September 2020 for studies reporting on GBS secondary to COVID-19. Results. We identified 63 articles; we included 32 studies in our review. A total of 41 GBS cases with a confirmed or probable COVID-19 infection were reported: 26 of them were single case reports and 6 case series. Published studies on SARS-CoV-2-related GBS typically report a classic sensorimotor type of GBS often with a demyelinating electrophysiological subtype. Miller Fisher syndrome was reported in a quarter of the cases. In 78.1% of the cases, the response to immunomodulating therapy is favourable. The disease course is frequently severe and about one-third of the patients with SARS-CoV-2-associated GBS requires mechanical ventilation and Intensive Care Unit (ICU) admission. Rarely the outcome is poor or even fatal (10.8% of the cases). Conclusion. Clinical presentation, course, response to treatment, and outcome are similar in SARS-CoV-2-associated GBS and GBS due to other triggers.

scholarly journals Guillain–Barré syndrome and Fisher syndrome: Case definitions and guidelines for collection, analysis, and presentation of immunization safety data

Vaccine ◽  
2011 ◽  
Vol 29 (3) ◽  
pp. 599-612 ◽  
Author(s):  
James J. Sejvar ◽  
Katrin S. Kohl ◽  
Jane Gidudu ◽  
Anthony Amato ◽  
Nandini Bakshi ◽  
...  
Keyword(s):  
Safety Data ◽  
Guillain Barre Syndrome ◽  
Case Definitions ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré
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