scholarly journals Atypical clinical presentation of COVID-19: a case of Guillain-Barrè Syndrome related to SARS-Cov-2 infection

Author(s):  
Angelo Michele Carella
2021 ◽  
Vol 2021 (9) ◽  
Author(s):  
Celeste Camargo ◽  
Tathagat Narula ◽  
Daniel A Jackson ◽  
Teresa Padro ◽  
W David Freeman

ABSTRACT Guillain-Barré syndrome (GBS) is an immune-mediated polyneuropathy, which is characterized by areflexia and ascending paresthesia which can progress to a respiratory failure. Certain conditions, such as vasculitis and heavy metal and drug toxicity, may have misleadingly similar clinical presentation to GBS. We describe a case of a patient with cystic fibrosis and intravenous colistin-induced neurotoxicity mimicking GBS. The patient had used inhaled colistin on five occasions with no adverse effects, however, developed symptoms on the second day of intravenous treatment. Overlapping findings between immune-mediated polyneuropathy and drug-induced neurotoxicity include limb paresthesia and decreased reflexes. Perioral tingling, however, is a common presentation of colistin-induced neurotoxicity, and therefore, is an important differentiating factor. Early diagnosis prevents further neurologic decline, extensive unnecessary workup and potentially harmful incorrect management.


2021 ◽  
Author(s):  
Yasmim Nadime José Frigo ◽  
Hendrick Henrique Fernandes Gramasco ◽  
Ana Flavia Andrade ◽  
Guilherme Drumond Jardini Anastácio ◽  
Stella de Angelis Trivellato ◽  
...  

Introduction: Guillain-Barré syndrome is an acute / subacute inflammatory polyradiculoneuropathy that classically results in flaccid areflex palsy. However, there are other possibilities of clinical presentation that must be remembered so that an adequate diagnosis and treatment is carried out. Case report: Female patient, 23 years old, without comorbidities, with complaint of paresthesia in extremities and right peripheral facial paralysis, having diagnosis until then of Bell’s Palsy. She denied previous or current infectious complaints. The neurological examination revealed facial diparesis, proximal weakness of the lower limbs that made walking difficult, tactile and painful hypoesthesia in the feet, with reflexes 1+/4+ in the lower limbs and 3+/4+ in the upper limbs. An investigation was started with CSF collection that showed albuminocytological dissociation (proteins 440 mg/dl and leukocytes 01 mm3). Neuroimaging exams showed contrast impregnation in facial and trigeminal nerves. A diagnosis of acute inflammatory polyradiculoneuropathy was made and treatment with human immunoglobulin was initiated for 5 days. Electroneuromyography showed peripheral, sensory-motor polyradiculoneuropathy and questioned the physiopathological possibility of juxtaparanodopathy. The patient presented a significant and early improvement after treatment. Conclusions: It is essential to consider that Guillain-Barré syndrome has symptom variability, especially according to its pathophysiology and clinical and electrophysiological variant, thus avoiding that conditions such as this one are underdiagnosed.


2016 ◽  
Vol 32 (S1) ◽  
pp. 59-61 ◽  
Author(s):  
Agni Sekhar Saha ◽  
Md. Fekarul Islam ◽  
Sukanta Bhattacharya ◽  
Prabhas Prasun Giri

1976 ◽  
Vol 4 (1) ◽  
pp. 46-52 ◽  
Author(s):  
D. J. McCleave ◽  
J. Fletcher ◽  
L. C. Cruden

The history, clinical presentation and pathological findings of the Guillain-Barré Syndrome are presented. An analysis is made of patients with this syndrome admitted to an intensive care ward over a six year period. Results and management are discussed.


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