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1
Kulas Søborg, Marie-Louise, Jacob Rosenberg, and Jakob Burcharth. "Case Report: Subacute onset of the motor-sensory axonal neuropathy variant of Gullain-Barré syndrome after epidural anesthesia." F1000Research 5 (June 22, 2016): 1462. http://dx.doi.org/10.12688/f1000research.9033.1.
Full textAbstract:
Guillain-Barré syndrome (GBS) is an acute ascending peripheral neuropathy, caused by autoimmune damage of the peripheral nerves. GBS can be divided into three subtypes: acute inflammatory demyelinating neuropathy, acute motor axonal neuropathy, and the more rare type, acute motor and sensory axonal neuropathy (AMSAN). Reports of AMSAN with onset after epidural anesthesia and spinal surgery are extremely rare, and the linkage between development of GBS and neuroaxial anesthesia remains conclusively unconfirmed. We present a case in which the patient developed subacute motor and predominantly sensory neuropathy following epidural blockade. The case emphasizes the need of including AMSAN in differential diagnostic considerations to changes in motor and sensory function following epidural anesthesia, allowing accelerated rehabilitation and relevant alleviating therapy.
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Cheng, Jocelyn, D. Ethan Kahn, and Michael Y. Wang. "The acute motor-sensory axonal neuropathy variant of Guillain-Barré syndrome after thoracic spine surgery." Journal of Neurosurgery: Spine 15, no. 6 (2011): 605–9. http://dx.doi.org/10.3171/2011.8.spine1159.
Full textAbstract:
Guillain-Barré syndrome (GBS) is the eponym used to describe acute inflammatory polyradiculoneuropathies, which manifest with weakness and diminished reflexes. Although the classic form of GBS is considered to be an ascending demyelinating polyneuropathy, several variants have been described in the literature, including the Miller-Fisher syndrome, acute panautonomic neuropathy, acute motor axonal neuropathy, and acute motor-sensory axonal neuropathy (AMSAN). Few cases of postoperative GBS have been documented, particularly for the AMSAN variant. The authors describe the case of a patient who developed AMSAN after thoracic spine surgery and highlight the importance of investigating new-onset weakness in the postoperative period.
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Pareja, Helen Brambila Jorge, Melina Costa Lopes de Sá, Eduardo Alves Canedo, et al. "Acompanhamento de paciente diagnosticado com Síndrome de Guillain-Barré com lesão axonal do tipo sensitivo-motor (AMSAN)." LUMEN ET VIRTUS 15, no. 39 (2024): 2021–30. http://dx.doi.org/10.56238/levv15n39-034.
Full textAbstract:
Guillain-Barre syndrome (GBS) is a rare inflammatory disease of the peripheral nervous system, with a prevalence of 1-4 cases per 100,000 population. It is characterized by acute flaccid paralysis with ascending motor and sensory symptoms, and can be electrophysiologically classified into subtypes such as acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), and acute sensory-motor axonal neuropathy (AMSAN). GBS, usually triggered by viral infections, can lead to serious complications like respiratory failure due to phrenic nerve palsy. The reported case study describes a patient with AMSAN, a severe and rare form of the disease, who presented with progressive weakness and areflexia, with a diagnosis confirmed by electroneuromyography and successful treatment with intravenous immunoglobulin. The prognosis is usually favorable with appropriate treatment, but may include complications and the need for prolonged rehabilitation.
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Putri, Gyang Hanandita Gusti, Nectarine Natasya Regitta Yasmin, and Shahdevi Nandar Kurniawan. "GUILLAIN-BARRÉ SYNDROME." JPHV (Journal of Pain, Vertigo and Headache) 4, no. 2 (2023): 46–50. http://dx.doi.org/10.21776/ub.jphv.2023.004.02.4.
Full textAbstract:
Guillain-Barré Syndrome (GBS) is an infection-preceded autoimmune disease attacking myelin sheath of neurons through molecular mimicry, causing neuron demyelination and conduction disruption. GBS is classified into four subtypes: Acute Inflammatory Demyelinating (AIDP), Acute Motor Axonal Neuropathy (AMAN), Acute Motor Sensory Axonal Neuropathy (AMSAN), and Miller Fisher Syndrome. It affects spinal radix which resulted in polyneuropathy, showing mainly symptoms of ascending paresis of the extremity and areflexia. Cerebrospinal fluid evaluation is essential to distinguish GBS from its vast differential diagnosis, with main finding of albuminocytologic dissociation. GBS needs to be managed as fast as possible with intravenous immunoglobulin administration or fresh frozen plasma exchange due to its fast progression.
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Kiraz, Mustafa, Abdullah Yılgör, Aysel Milanlıoğlu, Vedat Çilingir, Aydın Çağaç, and Sibel Özkan. "Clinical subtypes, seasonality, and short-term prognosis of Guillain-Barré syndrome in an Eastern city of Turkey." Neurology Asia 27, no. 4 (2022): 937–44. http://dx.doi.org/10.54029/2022wak.
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Background & Objective: This study aimed to analyze the frequency Guillain-Barré syndrome (GBS) subtypes and their relationship with clinical characteristics, seasonal variations and early prognosis in Van City, Turkey. Methods: Patients with GBS who were admitted between January 2007 and December 2017 and diagnosed with acute inflammatory demyelinating neuropathy (AIDP), acute motor axonal neuropathy (AMAN) or acute motor sensory axonal neuropathy (AMSAN) were reviewed. Demographics, season of clinical onset, history and type of preceding infection, the Hughes Disability Score (HDS) at admission and discharge were recorded. Results: Of a total 100 patients, 51% was diagnosed with AIDP, 25% with AMAN and the remaining 24% with AMSAN subtype. The most common seasonal onset was during the spring (34%), followed by the fall (30%). The history of gastroenteritis (GE) was present in 26% of the patients and these patients were more likely to have AMAN and AMSAN subtypes. HDS on admission and at discharge were significantly higher in patients with AMAN and AMSAN compared to those with AIDP (p=0.003 and p<0.001, respectively). The most important predictor of poor outcome at discharge was HDS on admission explaining between 50% and 80% of the total variance. Conclusion: There is a high prevalence of AMAN and AMSAN subtypes in Eastern region of Turkey. The history of GE, which is also commonly found in patients with GBS in this region, is more likely detected in patients with AMAN and AMSAN subtypes. Finally, clinical severity on admission is the most important contributor to clinical outcome at discharge.
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Vishnuram, Surya, Kumaresan Abathsagayam, and Prathap Suganthirababu. "Physiotherapy management of a rare variant of Guillain Barre Syndrome, acute motor and sensory axonal neuropathy (AMSAN) along with COVID-19 in a 35-year-old male –a case report." African Health Sciences 22, no. 3 (2022): 520–26. http://dx.doi.org/10.4314/ahs.v22i3.56.
Full textAbstract:
Introduction: COVID-19 emerged as a novel pandemic with serious illness. Acute motor and sensory axonal neuropathy, a Guillain-Barré syndrome variant also results in ventilator support, and bed-ridden state. Presence of COVID-19 along with GBS will cause serious complications if left untreated.
 Objective: To report the effect of physiotherapy in acute motor and sensory axonal neuropathy along with COVID-19 in Intensive care unit.
 Case description: A 35-year-old-male with AMSAN, alcoholic hepatitis, and hyponatremia, came with paraparesis, ventilated due to poor oxygen saturation, diagnosed to have COVID-19, reduced muscle power in right wrist extensors, hand grip and diaphragm.
 Method: 30 minutes physiotherapy session, thrice a day for a period of 4 weeks. The vital signs were taken as a primary outcome measure. Medical Research Council muscle power grading and Hughes functional grading scale were taken as secondary outcomes. All the outcome measures were assessed for 4 weeks.
 Results: The 4 weeks of physiotherapy program show significant improvements on health status, muscle power, and functional status of an AMSAN patient with COVID 19.
 Conclusion: From the results, it can be concluded that physiotherapy will be beneficial in AMSAN patients with COVID-19 in Intensive care units and further studies have to declare evidence-based practice.
 Keywords: Acute motor-sensory axonal neuropathy; Intensive care unit; COVID-19; Gullian Barre syndrome.
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Miscusi, Massimo, Antonio Currà, Carlo Della Rocca, Paolo Missori, and Vincenzo Petrozza. "Acute motor-sensory axonal neuropathy after cervical spine surgery." Journal of Neurosurgery: Spine 17, no. 1 (2012): 82–85. http://dx.doi.org/10.3171/2012.4.spine11932.
Full textAbstract:
The authors report the case of a 55-year-old man who presented with acute motor-sensory axonal neuropathy (AMSAN), a variant of Guillain-Barré syndrome with a poor prognosis, immediately after surgery for resection of a cervical chondroma. A misdiagnosis of spinal cord shock due to an acute surgical or vascular postoperative complication was initially made in this patient. Nevertheless, there was continuous transient improvement that was followed by progressive worsening, and further investigation was necessary. The diagnosis of AMSAN, associated with acute colitis caused by Helicobacter pylori, was made based on neurophysiological examinations and colonoscopy. Interestingly, the patient also developed nephrotic syndrome, which was thought to be a further complication of the autoimmune reaction. Delayed administration of immunoglobulins (400 mg/kg/day), mesalazine (800 mg 3×/day), and meropenem (3 g/day) was used to treat the Helicobacter infection and the autoimmune reaction, leading to restoration of renal function and slight neurological improvement. The patient's general condition and neurological status improved slightly, but he remained seriously disabled (Frankel Grade C). This case demonstrates that a new onset of neurological symptoms in the early postoperative period after spine surgery could be related to causes other than iatrogenic myelopathy, and that an early diagnosis can reduce neurological sequelae, leading to a better outcome.
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Mohan, Gurinder, Richa G. Thaman, and Sanjeev K. Saggar. "Acute Motor Sensory Axonal Neuropathy: A Variant of Guillain–Barré Syndrome—A Rare Case Report." AMEI's Current Trends in Diagnosis & Treatment 4, no. 2 (2020): 110–11. http://dx.doi.org/10.5005/jp-journals-10055-0110.
Full textAbstract:
ABSTRACT Background Guillain–Barré syndrome (GBS) is an immune-mediated disorder of the nervous system that shows acute or subacute onset. It is also known as Landry's paralysis. It is characterized by muscle weakness of legs and arms, limb paresthesias, and total or relative areflexia. Acute motor sensory axonal neuropathy (AMSAN) is a distinct subtype of GBS. It is not only a rare but severe variant that involves axonal degeneration in motor and sensory nerve fibers and has a prolonged recovery course. Case description A 60-year-old male presented to the emergency department having complaints of weakness, numbness, and tingling sensation in feet for the last fortnight, which ascended gradually towards the calves. He was observed to have a sensory disorder in hands, but not flaccid paralysis. The patient history and nerve conduction studies were indicative of AMSAN variant of GBS. Discussion In patients of AMSAN, the reduction of sural nerve amplitude is more pronounced as compared to acute inflammatory demyelinating polyneuropathy (AIDP) patients. In case of our patient, the electrophysiological feature indicated a more than 50% decrease in SNAP. A marked reduction in sensory nerve action potential and compound muscle action potential with only slightly decreased conduction velocities is a requirement for the diagnosis of axonal neuropathies, which is the trait seen in the reported case. How to cite this article Saggar SK, Thaman RG, Mohan G. Acute Motor Sensory Axonal Neuropathy: A Variant of Guillain–Barré Syndrome—A Rare Case Report. MEI's Curr Trends Diagn Treat 2020;4(2):110–111.
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Pattni, Vandana Indraprakash, and Hardini Prajapati. "Analysis of Nerve Conduction Parameters in Post-Covid-19 Patients with Neuropathic symptoms." International Journal of Health Sciences and Research 12, no. 8 (2022): 154–59. http://dx.doi.org/10.52403/ijhsr.20220822.
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Background: World is confronting various deleterious consequences of Covid-19. Neurological complications are of paramount importance amongst these. One of the uprooting neurological complications is of peripheral neuropathy. Nerve conduction study utilizes evaluation of conduction properties of nerves to diagnose and classify type of neuropathy. Objective: The present study aims to identify the type of neuropathy in post-covid-19 patients with neuropathic symptoms. Materials and Method: RMS SALUS software was used. Bilateral Median, Ulnar, Tibial and Common Peroneal motor nerves and Bilateral Median, Ulnar, Sural and Superficial peroneal sensory nerves were studied. Parameters included Compound muscle action potential (CMAP), Sensory nerve action potential (SNAP) and Nerve conduction velocity (NCV) measured in millivolt, microvolt and meter/second, respectively. Result: Eighteen post-covid-19 patients with neuropathic symptoms underwent the procedure. Fourteen of them were electrodiagnostically proven cases of Guillain Barre Syndrome (GBS). Variants of GBS included seven cases of Acute inflammatory Demyelinating Polyneuropathy(AIDP), six of Acute motor sensory axonal neuropathy (AMSAN), one of Acute motor axonal neuropathy (AMAN). Out of the rest of four patients, two had normal nerve conduction findings in spite of having symptoms of muscular weakness and numbness. Other two had mononeuropathy. Conclusion: While the neurological sequelae of Covid-19 are still underexplored, health care workers must be aware of the possible serious life threatening neurological complications as is GBS. Being an autoimmune disease, GBS can be triggered by Covid-19 infection. Nerve conduction study holds the mainstay for the diagnosis of neuropathy. Write abstract/summary of your article here. Key words: Covid-19, SARS-CoV-2, Acute Inflammatory demyelinating Polyneuropathy, Guillain Barre Syndrome, Nerve conduction study.
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Dowling, Jessica R., and Thomas J. Dowling. "A Rare Axonal Variant of Guillain-Barré Syndrome following Elective Spinal Surgery." Case Reports in Orthopedics 2018 (August 7, 2018): 1–4. http://dx.doi.org/10.1155/2018/2384969.
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Acute motor and sensory axonal neuropathy (AMSAN) is a rare axonal variant of Guillain-Barré syndrome. AMSAN is considered the most severe form of GBS, known for its rapid onset of severe symptoms, and often leading to quadriparesis within 7 days of initial symptom onset. We present a case of a middle-aged Caucasian female who developed AMSAN 2 weeks following an elective spinal surgery. Although rare, GBS has been reported as a complication of surgery. GBS classically presents as ascending motor weakness starting in the lower extremities following a gastrointestinal or upper respiratory tract infection. This patient’s GBS manifested slightly differently, with both sensory and motor symptoms of her thoracic region and lower extremities, with no preceding history indicative of infection. To the authors’ knowledge, this is the first reported case of AMSAN following spinal surgery. Because of its risk of significant morbidity and mortality, as well as similar presentation to more common spinal postoperative complications, GBS should always be included in the differential diagnosis whenever motor or sensory weakness is observed after spinal surgery.
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Oliveira, L. M., R. G. Cury, L. H. Castro, and R. Nitrini. "Concomitant Transverse Myelitis and Acute Axonal Sensory-Motor Neuropathy in an Elderly Patient." Case Reports in Immunology 2017 (2017): 1–3. http://dx.doi.org/10.1155/2017/7289474.
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Diagnosing concomitant transverse myelitis (TM) and Guillain-Barré syndrome (GBS) can be challenging. We report a case of an elderly patient presenting with acute sensory and motor disturbances in the four limbs, associated with urinary retention, ophthalmoparesis, facial weakness, and dysarthria. Electrodiagnostic studies were consistent with acute motor sensory axonal neuropathy (AMSAN), and imaging showed a longitudinally extensive tumefactive contrast-enhancing hyperintense spinal cord lesion extending from T6 to the cone. Concomitant AMSAN and TM have not been previously reported in the elderly. Comorbid TM and other GBS variants have been previously reported. Intravenous methylprednisolone, plasma exchange, cyclophosphamide, or combination therapies are usually used, although there are no randomized controlled studies regarding treatment choices.
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Wattanasit, Prangsai, and Pornchai Sathirapanya. "Anti-Ganglioside Antibody-Negative Miller Fisher and AMSAN Variant Guillain-Barré Overlap Syndrome." Case Reports in Neurology 12, no. 1 (2020): 92–96. http://dx.doi.org/10.1159/000506191.
Full textAbstract:
A case of Miller Fisher and acute motor sensory axonal neuropathy (AMSAN) variant Guillain-Barré (MFS/AMSAN-GBS) overlap syndrome is presented. The neurological presentation of the overlap syndrome was preceded by an upper respiratory tract infection. Eventually, severe weakness of bulbar and limb muscles, areflexia, ophthalmoplegia, ataxia, and respiratory insufficiency developed. The electroneuromyography revealed symmetrical axonal polyneuropathy which was dominant in both upper limbs. Although a panel of anti-ganglioside antibodies including anti-GQ1b was negative, immediate treatment with intravenous immunoglobulin resulted in dramatic response.
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M., Yashfeen, and Mugundhan K. "Clinical spectrum and treatment outcomes in variants of Guillain-Barré syndrome: a case series." International Journal of Research in Medical Sciences 12, no. 4 (2024): 1242–48. http://dx.doi.org/10.18203/2320-6012.ijrms20240848.
Full textAbstract:
Guillain-Barré syndrome (GBS) is an autoimmune polyradiculoneuropathy that is acute, typically severe, and fulminant. GBS has an incidence of 0.81-1.89 (median 1.11) per 100,000 person-years, and men are slightly more susceptible to GBS than females. 70% of individuals acquire this acute flaccid paralysis condition within 1-4 weeks following a respiratory infection or diarrhoea (especially Campylobacter jejuni). There are several identified subtypes of GBS, with acute inflammatory demyelinating polyneuropathy (AIDP) being the most prevalent. Additionally, there are two "axonal" subtypes: acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN), both of which are clinically severe. The clinical trial of ophthalmoplegia, ataxia, and areflexia characterizes a different subtype called Miller Fisher syndrome (MFS) linked to anti-GQ1b antibodies. The patient's medical history, along with neurological, electrophysiological, and cerebrospinal fluid tests, are used to diagnose GBS. Intravenous immunoglobulin (IVIG) and plasma exchange are effective treatments; however, newer approaches are required because 25% of patients eventually need mechanical ventilation, 20% are unable to walk, and 2-5% of patients may experience relapses.
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Singh, Anshu Man, Vinayak M. Sawardekar, Amit Jaiswal, and Maithilee M. Kale. "Clinical, laboratory, and electrophysiological presentations and treatment modalities in Guillain–Barré syndrome: A prospective study." Journal of Internal Medicine of India 17, no. 1 (2023): 7–12. https://doi.org/10.4103/upjimi.upjimi_14_24.
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INTRODUCTION: Guillain–Barré syndrome (GBS) is a rare autoimmune disorder causing acute inflammatory demyelinating polyneuropathy (AIDP), leading to muscle weakness, paralysis, and respiratory failure. MATERIALS AND METHODS: This single-center, prospective study was performed in the department of medicine of a tertiary care institute over a period of 18 months with 6 months of follow-up. This study enrolled 50 patients diagnosed with GBS. We analyzed medical records, clinical presentation, laboratory results, electrophysiological findings, and treatment modalities. RESULTS: This study enrolled 50 patients diagnosed with GBS, the mean age of patients was 38.5 ± 17.02 years, and males were predominant (70%). Quadriparesis was the most common motor complaint presented in 80%, whereas tingling and numbness were the most common sensory complaint (70%); 4% of patients had bowel and bladder involvement. Excessive sweating was the most common autonomic disorder, found in 44 (88%) patients. In a nerve conduction study, AIDP was the most common subtype seen in 28 (56%) patients; acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN) were seen in 11 (22%) patients each. In patients with AIDP, distal latency prolongation was the most common findings (86%), while in AMAN and AMSAN, a decrease in CAMP was the most prevalent finding. Ventilatory support was needed in 18 (36%) patients enrolled in the study. Mortality was reported in 8 (16%) patients. In AMAN-AMSAN variants, IV Ig therapy appeared to have better outcomes at 6 months as compared to plasma exchange therapy. CONCLUSION: This study provides valuable insights into the clinical, laboratory, and electrophysiological features of GBS and highlights the effectiveness of IVIG as a treatment modality. Early recognition and treatment are crucial for optimal outcomes in GBS patients.
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Komal Patekar, Komal Patekar, Yash Patil Yash Patil, and Anuj Pawar Anuj Pawar. "Gullain-Baree syndrome: A comprehensive review about detailed basic information of the syndrome." International Journal of Pharmaceutical Research and Applications 10, no. 3 (2025): 1238–47. https://doi.org/10.35629/4494-100312381247.
Full textAbstract:
Guillain-Barré Syndrome is the most common cause of acute neuromuscular paralysis worldwide, often triggered by infections such as Campylobacter jejuni, Epstein-Barr virus, or influenza. It is an autoimmune disorder where the body’s immune system attacks the peripheral nerves, leading to sudden and progressive muscle weakness, sometimes resulting in respiratory failure. The syndrome includes several variants: Acute Inflammatory Demyelinating Polyneuropathy (AIDP), Acute Motor Axonal Neuropathy (AMAN), Acute Motor-Sensory Axonal Neuropathy (AMSAN), and Miller-Fisher Syndrome (MFS). Diagnosis is primarily clinical, supported by cerebrospinal fluid analysis and electrophysiological tests. Epidemiological data show GBS incidence varies by region and age, with higher rates in older adults and a male predominance. The condition’s pathophysiology involves molecular mimicry, where antibodies generated by infections cross-react with nerve tissues, leading to demyelination or axonal damage. The review also discusses immunological aspects, historical pathology studies, vaccine associations (such as with influenza and COVID-19 vaccines), and includes a detailed case study of a 5- year-old boy with severe GBS. The document emphasizes the need for continued research into improved treatments and highlights recent advances in understanding GBS mechanisms and management
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Pegg, E. J., S. K. Chhetri, U. G. Lekwuwa, and T. Majeed. "An Overlapping Case of Miller Fisher Syndrome, Bickerstaff’s Encephalitis, and the ASMAN Variant of Guillain-Barre Syndrome." Case Reports in Neurological Medicine 2016 (2016): 1–3. http://dx.doi.org/10.1155/2016/1596850.
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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.
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Jamil, Anila, Nighat Rashid, MUHAMMAD SARWAR, FAREEHA KAUSAR, GHAZALA SHAFFQAT, and UMER WAQAR AZEEM. "Response and Clinical Outcome of Critically Ill Children with Guillain Barre Syndrome admitted to PICU of Children’s Hospital Lahore." Pakistan Postgraduate Medical Journal 31, no. 01 (2021): 37–41. http://dx.doi.org/10.51642/ppmj.v31i01.364.
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Objective: To analyze patients with Guillain Barre Syndrome (GBS) requiring intensive care unit (ICU) admission, their course, response to treatment and outcome.
 Methods: A retrospective study conducted at ICU of The Children’s Hospital Lahore in 194 children with diagnosis of GBS from June 2018 to May 2020. Demographic profile, clinical features, treatment, duration of mechanical ventilation, length of ICU stay and outcome was noted. 
 Results: 
 Mean age of children was 5.95 ± 3.1 years with male predominance 136 (70 %). Major proportion were in range of 1-5 years 93(47.9%). Mean duration of ICU stay was 21.3±34.4 days. Out of 194 patients 125(64%) received IVIGs while 112 (57.7%) required mechanical ventilation because of rapidly progressive weakness within 24 hours of admission and those who remained on mechanical ventilation for longer period showed AMSAN (Acute motor sensory axonal neuropathy) type of GBS ( p value <0.001). Tracheostomy was performed in 22.7% of patients who were difficult to wean off from ventilator. Among nerve conduction studies AIDP (Acute inflammatory demyelinating polyneuropathy) was predominant 48% associated with p value <0.001 in those who showed complete recovery, followed by AMSAN 24%, AMAN ( Acute motor axonal neuropathy) 13.4% and miscellaneous 13.9 %. Regarding outcome complete recovery was seen in 28%, minimal residual disability in 70% and 1.5% remained ventilator dependent.
 Conclusion:
 Patients of severe GBS often require prolong respiratory support and ICU care. The indicators of poor outcome are rapidly progressive course, severe weakness and axonal neuropathy leading to longer duration on mechanical ventilation.
 KEYWORDS: 
 Guillain Barre Syndrome, Outcome, intensive care unit (ICU)
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Canul-Reich, Juana, Juan Frausto-Solís, and José Hernández-Torruco. "A Predictive Model for Guillain-Barré Syndrome Based on Single Learning Algorithms." Computational and Mathematical Methods in Medicine 2017 (2017): 1–9. http://dx.doi.org/10.1155/2017/8424198.
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Background. Guillain-Barré Syndrome (GBS) is a potentially fatal autoimmune neurological disorder. The severity varies among the four main subtypes, named as Acute Inflammatory Demyelinating Polyneuropathy (AIDP), Acute Motor Axonal Neuropathy (AMAN), Acute Motor Sensory Axonal Neuropathy (AMSAN), and Miller-Fisher Syndrome (MF). A proper subtype identification may help to promptly carry out adequate treatment in patients. Method. We perform experiments with 15 single classifiers in two scenarios: four subtypes’ classification and One versus All (OvA) classification. We used a dataset with the 16 relevant features identified in a previous phase. Performance evaluation is made by 10-fold cross validation (10-FCV). Typical classification performance measures are used. A statistical test is conducted in order to identify the top five classifiers for each case. Results. In four GBS subtypes’ classification, half of the classifiers investigated in this study obtained an average accuracy above 0.90. In OvA classification, the two subtypes with the largest number of instances resulted in the best classification results. Conclusions. This study represents a comprehensive effort on creating a predictive model for Guillain-Barré Syndrome subtypes. Also, the analysis performed in this work provides insight about the best single classifiers for each classification case.
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Sharma, Krishna Sagar, Rupa Singh, and Gauri Shankar Shah. "Guillain Barre Syndrome: Major Cause of Acute Flaccid Paralysis in Children and Adolescents of Nepal." Journal of Nepal Paediatric Society 31, no. 2 (2011): 93–97. http://dx.doi.org/10.3126/jnps.v31i2.4065.
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Introduction. Guillain Barre Syndrome (GBS) is a post infectious polyneuropathy involving mainly motor but sometimes sensory and autonomic nerves. It is an acquired disease of the peripheral nerves that is characterized by rapidly progressing paralysis, areflexia and albumino-cytological dissociation in CSF. Methodology: Prospective, descriptive, observational, hospital based study was carried out to find out the clinico-epidemiological features of GBS including existing treatment modalities and its outcome. All cases fulfilled the criteria for AFP (Acute flaccid Paralysis) surveillance was included. Cases were reviewed for full medical history and examinations. To confirm the diagnosis, necessary investigations were carried out and combined with clinical symptoms. Results: Thirty patients were included in the study during study period. Among them 90% were diagnosed as GBS, 7.4% patients of GBS were associated with hypokalemic paralysis, 7.4% diagnosed as transverse myelitis and 3.7% diagnosed as idiopathic neuropathy. Different types of GBS were classified as AIDP (Acute inflammatory demyelinating polyneuropathy) 62.96%, AMAN (Acute motor axonal neuropathy) - 25.52%, AMASAN (Acute motor and sensory axonal neuropathy) - 3.3% and MFS (Miller fisher's syndrome) - 6.6% according to NCV result. Male female ratio is 1.7:1.0. There was 14.8% patients had relapse within 5 year. Associated diseases were URTI, pneumonia, sore throat and diarrhea. Facial Nerve palsy was commonest cranial nerve involvement.Sixty percentage of patients presented with sensory symptoms. There was transient bowel and bladder involvement in 20% of the cases. 69.2% patients became bed ridden at the nadir. There was albumin-cytological dissociation in 80% case. Majority of patients improved with supportive treatment alone, 19.5% patient required ventilator support among them 40% died. 7.4% of cases expired during treatment. Half of the patients fully recovered within 3 months. Conclusion: GBS is the commonest cause of AFP, AIDP being commonest subtype in our setting. We have to improve our existing treatment facilities and extend to different centers to detect and treat GBS. Most of the patients improve with supportive treatment alone. Ventilator support indicates grave prognosis. Key words: GBS (Gullein Barre Syndrome); AFP (Acute flaccid Paralysis); AIDP (Acute inflammatory demyelinating polyneuropathy; AMAN (Acute motor axonal neuropathy); AMASAN (Acute motor and sensory axonal neuropathy); MFS (Miller fisher's syndrome). DOI: 10.3126/jnps.v31i2.4065 J Nep Paedtr Soc 2010;31(2):93-97
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Toopchizadeh, Vahideh, Mohammad Barzegar, Negar Taleschian-Tabrizi, Fariba Pashazadeh, and Nasim Rashedi. "Long-term Disability and Poor Outcome Predictors of Guillain-Barre Syndrome in Children: A Systematic Review." Journal of Pediatrics Review 11, no. 1 (2023): 11–24. http://dx.doi.org/10.32598/jpr.11.1.1066.1.
Full textAbstract:
Background: Guillain-Barre syndrome (GBS) is an immune-mediated polyneuropathy and a common cause of acute ascending weakness in children. Objectives: This study aims to report long-term disability and poor outcome predictors of GBS in children. Medline (via Pubmed), Embase, Cochrane Library, Web of Science, and Scopus database was searched for relevant studies until April 2022, with a designated search strategy, using MeSH terms and free keywords. Methods: Studies evaluating functional outcomes of GBS in children with at least one year of follow-up were included. All studies achieved acceptable quality for inclusion. After selecting studies based on inclusion criteria, data were extracted based on a modified standardized Joanna Briggs Institute (JBI) data extraction tool, and the methodological quality of studies were reviewed using the Joanna Briggs Institute (JBI) critical appraisal tool. Results: Fourteen studies were included in this systematic review consisting of 1141 patients (647 males, 466 females, and 28 unclassified). Follow-up duration varied from one year to 11 years. The prevalence of the GBS subtype was as follows, acute inflammatory demyelinating polyneuropathies (AIDP) 46.6%, acute motor axonal neuropathy (AMAN) 30.2%, acute motor and sensory axonal neuropathy (AMSAN) 6.8% and Miller fisher 6.1%. The most commonly reported poor outcome after at least one year of follow-up was walking disabilities and gait disorders. Motor deficits and weakness, sensory complaints, including pain or paresthesia and fatigue were other prevalent residual symptoms. Axonal form of GBS was the most reported poor outcome predictor, followed by Hughes disability score >3, a delay in independent walking, artificial ventilation, and rapid progression of symptoms. Conclusions: Despite the good prognosis of GBS in children, they could suffer long-term sequels, especially in walking abilities and gait. The axonal form is considered a crucial poor predictive factor.
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Tutar, Nurhan Kaya, Tuğba Eyigürbüz, Zerrin Yildirim, and Nilufer Kale. "A variant of Guillain-Barre syndrome after SARS-CoV-2 vaccination: AMSAN." Ideggyógyászati szemle 74, no. 7-8 (2021): 286–88. http://dx.doi.org/10.18071/isz.74.0286.
Full textAbstract:
Coronavirus disease 2019 (COVID-19) is a respiratory infection that has rapidly become a global pandemic and vaccines against SARS-CoV-2 have been developed with great success. In this article, we would like to present a patient who developed Guillain-Barré syndrome (GBS), which is a serious complication after receiving the inactive SARS-CoV-2 vaccine (CoronaVac). Case report – A 76-year-old male patient presented to the emergency department with nine days of progressive limb weakness. Two weeks prior to admission, he received the second dose of CoronaVac vaccine. Motor examination revealed decreased extremity strength with 3/5 in the lower extremities versus 4/5 in the upper extremities. Deep tendon reflexes were absent in all four extremities. Nerve conduction studies showed predominantly reduced amplitude in both motor and sensory nerves, consistent with AMSAN (acute motor and sensory axonal neuropathy). Clinicians should be aware of the neurological complications or other side effects associated with COVID-19 vaccination so that early treatment can be an option.
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Zutshi, Kalpana. "Comparative Study between COVID Associated Guillan Barre Syndrome and Non-COVID Associated Guillan-Barré Syndrome." Journal of Advanced Research in Medical Science & Technology 08, no. 03 (2021): 10–12. http://dx.doi.org/10.24321/2394.6539.202110.
Full textAbstract:
More than 12 million people have been infected with COVID-19 worldwide, with more than 500,000 deaths to date.1 Although COVID-19 research is rapidly evolving, new findings must be thoroughly scrutinised before any conclusions or treatment protocols are established or amended.2 Although COVID-19 is most usually associated with respiratory symptoms such as cough and dyspnea; it has recently been associated with a neurotropic presentation.3 Guillain-Barré Syndrome (GBS) is best described as an acute inflammatory polyradiculoneuropathy clinically characterized by areflexia and progressive weakness of arms and legs. Though, many rare variants of GBS have been described, the commonly observed subtypes such as Acute Motor Axonal Neuropathy (AMAN), Acute Motor Sensory Axonal Neuropathy (AMSAN) and Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) tend to fulfil the above-mentioned criteria.4 Recently, several case reports have suggested a relationship between the occurrence of Guillain-Barré syndrome (GBS) and a previous SARS-CoV-2 infection, which preceded the GBS onset by up to 4 weeks. Therefore, a post-infectious dysregulation of the immune system, triggered by SARS- CoV2, appears to be the most probable cause COVID-19 is a systemic disorder presenting typically with fever and respiratory symptoms but neurological manifestations such as acute cerebrovascular diseases, seizures, ageusia, anosmia meningitis, encephalitis and skeletal muscle involvement were soon reported.5 More recently, an increase in case reports of Guillain-Barré syndrome (GBS) in people infected with SARS-CoV-2 has prompted concerns about a possible link.
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Gupta, Anupam, Maitreyi Patil, Meeka Khanna, Rashmi Krishnan, and Arun B. Taly. "Guillain–Barre Syndrome in Postpartum Period: Rehabilitation Issues and Outcome – Three Case Reports." Journal of Neurosciences in Rural Practice 08, no. 03 (2017): 475–77. http://dx.doi.org/10.4103/jnrp.jnrp_474_16.
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ABSTRACTWe report three females who developed Guillain–Barre Syndrome in postpartum period (within 6 weeks of delivery) and were admitted in the Neurological Rehabilitation Department for rehabilitation after the initial diagnosis and treatment in the Department of Neurology. The first case, axonal variant (acute motor axonal neuropathy [AMAN]) had worst presentation at the time of admission, recovered well by the time of discharge. The second case, acute motor sensory axonal neuropathy variant and the third case, AMAN variant presented at the late postpartum period. Medical treatment was sought much later due to various reasons and both the patients had an incomplete recovery at discharge. Apart from their presentations, rehabilitation management is also discussed in some detail.
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Khazaei, Mojtaba, Fatemeh Ghasemi, Mehrdokht Mazdeh, Elham Khanlarzadeh, and Masoud Ghiasian. "Epidemiologic and Clinical Characteristics of Guillain-Barré Syndrome in Patients Referred to Sina Hospital in Hamadan in 2018." Epidemiology and Health System Journal 9, no. 4 (2022): 150–54. http://dx.doi.org/10.34172/ehsj.2022.27.
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Background and aims: Guillain-Barré syndrome (GBS) has several types, some of which damage myelin and some others cause axonal damage. Detecting the type of GBS is important in determining the type of treatment and its prognosis. This study was conducted to investigate the epidemiological characteristics of GBS and its variants in patients referred to Sina hospital in Hamadan, Iran, in 2018. Methods: In this cross-sectional study, 51 patients who were admitted to Sina hospital and diagnosed with GBS in 2018 were examined. Demographic data, GBS type, disease outcomes, and pre-clinical and clinical findings of patients were collected. Data were then analyzed using the Stata software version 12, and P value<0.05 was considered statistically significant. Results: Of the 51 investigated patients, 34 (66.66%) were male. The most common variant type was acute inflammatory demyelinating polyneuropathy (AIDP) with 27.45% of cases followed by acute motor axonal neuropathy (AMAN) with 19.61% of cases. Further, the highest average hospitalization days (11.1±11.7 days) were for chronic inflammatory demyelinating polyneuropathy (CIDP) patients, while the lowest (6.85±1.91 days) was for AIDP patients (P<0.001). All CIDP cases occurred in spring, and 71.43% of AIDP cases occurred in summer. Moreover, all 7 cases with acute motor and sensory axonal neuropathy (AMSAN) syndrome and the only case with the miller-fisher syndrome (MFS) occurred in fall (P<0.001). Conclusion: According to the results of this study, most variants of GBS in Hamadan province were AIDP in demyelinating form and AMAN variant in the axonal deterioration form. However, studies with a larger sample size are recommended in the west of Iran to better understand the epidemiology and to ensure common types of GBS.
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Sullo, Federica, Milena Motta, Pierluigi Smilari, Luigi Rampello, Filippo Greco, and Piero Pavone. "Acute Motor Axonal Neuropathy in a 5-Month-Old Child." Journal of Pediatric Neurology 18, no. 03 (2019): 171–74. http://dx.doi.org/10.1055/s-0039-1698816.
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AbstractGuillain–Barré syndrome (GBS) is an acute inflammatory polyneuropathy characterized by rapidly progressive, essentially symmetric weakness and areflexia in a previously otherwise healthy child. It is the most common cause of acute flaccid paralysis in children, and its reported incidence is 1 to 2/100,000 population. Prior infection is a well-established predating event in GBS. The commonly recognized variants of GBS are acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor sensory axonal neuropathy, and Miller–Fisher syndrome. AIDP is the most prevalent form. As Guillain–Barrè syndrome represents an important differential diagnosis in infancy with pronounced and progressive hypotonia, we herein report a case of AMAN in a 5-month-old male infant without known exposure to immunomodulating factors or infections.
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Bishay, R. H., J. Paton, and V. Abraham. "Variant Guillain-Barré Syndrome in a Patient with Non-Hodgkin’s Lymphoma." Case Reports in Hematology 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/979237.
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We report a 72-year-old female patient with diffuse large B cell non-Hodgkin’s lymphoma (NHL) with previous treatment with standard chemotherapy presenting as an acute, ascending, sensorimotor polyneuropathy. Nerve conduction studies and lumbar puncture supported a rare, but ominous, axonal variant of Guillain-Barré Syndrome (GBS) known as acute motor and sensory axonal neuropathy (AMSAN), which is distinguished from the more common, acute demyelinating forms of GBS. Previous reports have largely focused on toxicities secondary to chemo- or radiotherapy as a major contributor to the development of acute neuropathies in malignancy. Clinicians should also be mindful of direct neoplastic invasion or, less commonly, paraneoplastic phenomenon, as alternative mechanisms, the latter possibly reflecting immune dysregulation in particularly aggressive lymphomas. At the time of writing, this is the first report in the literature of an axonal variant of GBS in a patient with diffuse large B cell NHL. A discussion regarding common and uncommon neuropathies in haematological malignancies is made, with a brief review of the anecdotal evidence supporting a paraneoplastic association with GBS or its variant forms in the setting of lymphoma.
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Agha Abbaslou, Mojgan, Maryam Karbasi, and Hossein Mozhdehipanah. "A Rare Axonal Variant of Guillain-Barré Syndrome as a Neurological Complication of COVID-19 Infection." Archives of Iranian Medicine 23, no. 10 (2020): 718–21. http://dx.doi.org/10.34172/aim.2020.93.
Full textAbstract:
Guillain–Barré syndrome (GBS) is a neurological disorder accompanied by several neurological signs and symptoms including progressive weakness and diminished or decreased reflexes. GBS was reported as one of the several neurological complications in MERS-CoV and SARS-CoV outbreaks. Several studies have reported GBS as a neurological complication in recent COVID-19 outbreak. We report on the case of a 55-years -old female who was hospitalized with dyspnea, dry cough, and myalgia. She developed Acute Motor & Sensory Axonal Neuropathy (AMSAN), a rare variant of GBS signs and symptoms including decreased muscle strength and pinprick sensation in both lower extremities during her hospitalization.
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Liu, David Y., Jessica R. Hollenbach, Jason A. Gregorin, and Jonathan H. Wynbrandt. "A Case of Acute Motor Sensory Axonal Neuropathy: A Variant of Guillain-Barré Syndrome, with Possible Syndrome of Irreversible Lithium-Effectuated Neurotoxicity." Case Reports in Medicine 2020 (April 20, 2020): 1–4. http://dx.doi.org/10.1155/2020/4683507.
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Acute Motor Sensory Axonal Neuropathy (AMSAN) is a rare and severe variant of Guillain-Barré syndrome (GBS) that has a prolonged recovery course. GBS is often suspected due to ascending muscle weakness, sensation difficulties, respiratory compromise, and antecedent diarrhea. The diagnosis of GBS is supported by cerebrospinal fluid analysis showing albuminocytologic dissociation. Electromyogram and nerve conduction study confirm the diagnosis and allow for further classification by variant. Treatment involves either IV immune globulins or plasmapheresis, and patients typically recover. However, depending on the variant and severity, patients may ultimately require prolonged mechanical ventilation with tracheostomy. In these cases, they may continue to have persistent muscle and sensation abnormalities requiring long-term care. We present a unique case of a 38-year-old female patient with decade-long use of lithium for bipolar disorder that presented with acute lithium toxicity. Though she was ultimately diagnosed with AMSAN, the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) may have also contributed to her persistent neurological sequelae.
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Daoud, Mahmoud H. S., Mohmed Hussien Ahmed Mohmed, Mohamed Khalaf Allah Saeed, et al. "Pattern of Clinical Profile and Outcome of Gillian Barre Syndrome in Sudanese Patients." Journal of BioMed Research and Reports 4, no. 1 (2024): 1–6. http://dx.doi.org/10.59657/2837-4681.brs.24.059.
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Introduction: Guillian Barre'-Syndrome (GBS) is an acute, autoimmune disease affecting spinal roots and peripheral nerves, characterized by a rapidly progressive, ascending weakness of the extremity, trunk and even respiratory and facial muscles and with minor sensory and autonomic dysfunction. As in Sudan there is no enough data regarding the pattern of presentation and outcome of GBS, our research aimed to study clinical profile, electrophysiological variant, and outcome of Sudanese patients diagnosed with (GBS). Methods: A multi centers cross-sectional hospital-based study conducted in Khartoum from March to September 2020, 62 patients enrolled in the study, structured questionnaire consists of personal data, clinical history, examination findings, electrophysiological study result, management and outcome is used to assess the clinical profile and outcome of the disease. Results: The study revealed that males and females are equally represented, 70% patients are between 18 years and 50 years. The onset of the weakness was less than or equal 3 days in 33.9% of patients, from 4 to 7 days in 41.9%, from 8 to 14 days in 11.3% and above 14 days in 12.9%.40.3% patients had Evidence of autonomic dysfunction. The majority of patients presented with weakness that started in the lower limbs (93.5%), in (4.8%) the weakness started in the upper limbs and then descend. In (1.6%) the weakness started in the pharyngeal and respiratory muscles from the start. Sensory complains were observed in 54 patients (87.1%), 3 patients (4.8%) developed urinary bladder incontinence and 36 patients (58.1%) had back pain at the onset of the disease. On clinical examination; (98.4%) of patients had absent reflexes, (35.5%) had bilateral facial nerve palsy and (4.8%) had unilateral facial nerve pals. Based on the electrophysiological studies, (37.09 %) were recorded as acute motor axonal neuropathy (AMAN), (29.03%) as acute inflammatory demyelinating poly neuropathy (AIDP) and (29.03%) as acute motor-sensory axonal neuropathy (AMSAN). Regarding the outcome, 30 patients (48.4%) fully recovered, 25 patients (40.3%) recovered with motor deficit, and 7 patients (11.3%) unfortunately died. Conclusion: This study concluded that Guillian Barre'-Syndrome (GBS) in Sudanese population mainly affects age group from 18 to 50 years with variable maximum onset of weakness, presentation and outcome. Lower limb weakness and absent reflexes were the most presenting features. NCS showed axonal type of GBS found to be in nearly 66% of patients and 40% showed clinical evidence of dysautonomia.
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Cavirani, Benedetta, Margherita Baga, Carlo Alberto Cesaroni, et al. "Guillain-Barrè Syndrome—Retrospective Analysis of Data from a Cohort of Patients Referred to a Tertiary Care Pediatric Neuromuscular Center from 2000 to 2017: Electrophysiological Findings, Outcomes, and a Brief Literature Review." Medicina 60, no. 9 (2024): 1490. http://dx.doi.org/10.3390/medicina60091490.
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Background and Objectives: Guillain-Barré syndrome (GBS) is the most frequent cause of acute flaccid paresis in children. The aim of this study was to describe the clinical and electrophysiological findings and outcomes of children with GBS diagnosed in our unit. Moreover, the literature on pediatric GBS cases from the past 5 years was reviewed. In this retrospective study, we reported data on 12 patients (9 male and 3 female patients; mean age: 5 y, 4 mo; range: 9 mo–11 y) clinically diagnosed at the Child Neurology Unit of the AUSL-IRCCS of Reggio Emilia, Italy, between 2000 and 2017 and a brief analysis/comparison with data from the literature. Materials and Methods: Data were collected from medical charts. Results: In our cohort, male patients were more frequent than female ones (9 vs. 3), and upper respiratory tract infection (n = 8, 66.7%) was the most frequent triggering factor. The main clinical symptoms on admission were distal lower limbs’ weakness with gait difficulties (83.3%), pain (50%), upper limbs’ weakness (50%), and dysphagia for liquids (25%). Peripheral neurophysiological studies revealed acute inflammatory demyelinating polyradiculoneuropathy (AIDP) in 66.6% of the children, acute motor and sensory axonal neuropathy (AMSAN) in 25%, and acute motor axonal neuropathy (AMAN) in 8.3%. Ten individuals (83.3%) received timely treatment with intravenous immunoglobulins (IVIG), and, out of these ten patients, 58% received concomitant treatment with IV methylprednisolone because of a progressive disease course. Complete remission was observed in the majority of individuals (91.6%) within 6 months of symptom onset. Conclusions: Different subtypes of GBS can affect children; however, the outcome is usually positive. Early treatment appears to be important for a favorable outcome.
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Frigo, Mariane, Alessandra Ares, Fabiane Aparecida Baruffi, et al. "Atuação fisioterapêutica Hospitalar na Neuropatia Axonal Sensitivo-Motora Aguda: relato de caso." Revista Neurociências 33 (July 1, 2025): 1–13. https://doi.org/10.34024/rnc.2025.v33.19983.
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Introduction. Guillain–Barré syndrome is an inflammatory disease of the peripheral nervous system and is the most common cause of acute flaccid paralysis. Objective. To report the clinical case of a patient diagnosed with Acute Sensory-Motor Axonal Neuropathy (AMSAN), its treatment, the physiotherapeutic approach and the evolution of the clinical condition during the period of hospitalization. Method. This is a case report that occurred at the University Hospital of Western Paraná, carried out through the analysis of electronic medical records (TASY Software). Case Report. Male patient, 33 years old, admitted to the Emergency Room of the University Hospital of Western Paraná on 12/20/2023. Referred due to weakness and paresthesia in the lower limbs that began twenty days ago and with progressive and gradual worsening. In the Electromyography exam, he was diagnosed with AMSAN, which is a severe variant of GBS. Within a few weeks, his condition worsened and on January 25, 2024, he was transferred from the ward to the Intensive Care Unit (ICU) due to an episode of bronchoaspiration. Upon admission to the ICU, the medical team opted for orotracheal intubation. He was discharged to the ward on March 26, 2024. The patient underwent physical therapy daily throughout his hospitalization, totaling 24 weeks. Conclusion. Physical therapy was essential in the rehabilitation of the respiratory and musculoskeletal systems, contributing to improving muscle strength, postural control, and patient autonomy.
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Palmeri, Maria J., Diana Bronshteyn, Ronda Facchini, David Masur, John McGinley, and Erica Weiss. "A-163 Neuropsychological Profile of Early Onset ADEM and AMSAN." Archives of Clinical Neuropsychology 37, no. 6 (2022): 1318. http://dx.doi.org/10.1093/arclin/acac060.163.
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Abstract Objective: We present the neuropsychological profile of a 9-year-old girl with a history of waxing and waning ataxia, initially diagnosed at 18 months of age, with Acute Disseminated Encephalomyelitis (ADEM), later thought to be axonal motor sensory neuropathy (AMSAN). ADEM is a rapid onset neuroinflammatory disease typically seen in children ages 3-10 following infection, which results in demyelinating lesions. AMSAN is a rare variant of Guillain-Barre´ syndrome causing muscle/sensation difficulty. Common long-term cognitive correlates of ADEM include attention, processing speed and internalizing problems in the context of average overall cognition. Method: Comprehensive neuropsychological evaluation referral by neurology to assist with continued workup given atypical history and unclear academic difficulties. Initial symptom workup revealed signal changes in spinal cord and demyelinating lesions in the left frontal lobe and upper cervical spine. She was treated with intravenous immunoglobulins (IVIG), but symptoms returned several months later and then again. Subsequent improvements with therapy for ataxia, speech and feeding difficulties. Results: Overall cognitive functioning in the low average range with notable and extensive attentional limitations requiring continual prompting. Evaluation also revealed below grade and age level performance in all academic areas, significant oromotor and gross motor coordination difficulties, and mild self-esteem issues in this child who presented much younger than her chronological age. Conclusions: This case demonstrates the importance of neuropsychological evaluation in pediatric paraneoplastic motor/sensory motor syndromes. While underlying cause of demyelination and ataxia in this case remains unclear, cognitive findings revealed significant areas that require intervention which could have been identified and supported earlier in her development.
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KUMARI, W., T. DAS, A. DAS, JS RANA, M. LAKHAIR, and M. IRFAN. "THE FREQUENCY OF DIFFERENT CAUSES OF PREDOMINANT MOTOR NEUROPATHY IN PATIENTS PRESENTING AT TERTIARY CARE HOSPITAL." Biological and Clinical Sciences Research Journal 2024, no. 1 (2024): 1014. http://dx.doi.org/10.54112/bcsrj.v2024i1.1014.
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Predominant motor neuropathy (PMN) encompasses a variety of neuropathies primarily affecting motor nerves, leading to muscle weakness and functional impairment. Identifying the causes of PMN is crucial for diagnosis and treatment planning. Objective: The present study aims to determine the frequency of different causes of predominant motor neuropathy in patients at a tertiary care hospital. Methods: This cross-sectional study was conducted at the Department of Neurology, Civil Hospital Karachi, from March 27, 2022, to September 27, 2022, following ethical approval from the institutional review board. A total of 139 patients aged 15-70 years, of either sex, diagnosed with PMN were included through non-probability consecutive sampling. Patients with predominant sensory neuropathy or mixed neuropathies were excluded. Data were analyzed using statistical methods to determine the frequency of various causes of PMN, with particular attention to gender and diabetes status. Results: The most frequent cause of neuropathy was Acute Motor Axonal Neuropathy (AMAN) (26.6%), followed by Acute Inflammatory Demyelinating Polyneuropathy (AIDP) (21.58%), Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) (19.4%), and Charcot-Marie-Tooth disease (16.5%). Less common causes included multifocal motor neuropathy (8.6%), porphyria (3.6%), lead intoxication (2.88%), and familial amyloid neuropathy type 2 (0.7%). There were significant differences in the frequency of neuropathy causes based on gender (p = 0.011) and diabetes status (p = 0.006). Conclusion: The study identified Acute Motor Axonal Neuropathy as the most frequent cause of predominant motor neuropathy, followed by Acute Inflammatory Demyelinating Polyneuropathy. These findings underscore the importance of recognizing specific causes of PMN for appropriate management.
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de Castillo, Lennie Lynn Chua, Jose Danilo Bengzon Diestro, Katrina Hannah Dizon Ignacio, and Paul Matthew Dimaguila Pasco. "A rare mimic of acute stroke: rapidly progressing Miller-Fisher Syndrome to acute motor and sensory axonal neuropathy variant of Guillain-Barre Syndrome." BMJ Case Reports 12, no. 3 (2019): e228220. http://dx.doi.org/10.1136/bcr-2018-228220.
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Ophthalmoplegia, ataxia and areflexia characterise the clinical triad of Miller-Fisher Syndrome (MFS). When the disease presents acutely, it can mimic posterior circulation stroke. We describe a case of an adult patient presenting with sudden dizziness, diplopia, vomiting, and loss of balance. She was initially managed as a case of a brainstem stroke, but the progression of craniopathies without deterioration in sensorium coupled with areflexia clinched the diagnosis of MFS two days into her admission. On the third day, her MFS progressed rapidly to acute motor and sensory axonal neuropathy (AMSAN) variant of Guillain-Barre Syndrome, a rare occurrence in patients with MFS, with only four reported cases including our own. Among the four cases, ours is the only one still non-ambulatory eight months after the initial onset of symptoms. The case highlights the importance of early recognition of MFS in patients with ophthalmoplegia and ataxia despite initially normal reflexes.
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Hossain, SM Monowar, Zahed Ali, Mohammad Motiur Rahman, Md Aolad Hossain, Pallab Kanti Saha, and Sultana Nadira Rahman. "Electrophysiological patterns in patient with Guillain-Barre syndrome." BIRDEM Medical Journal 12, no. 1 (2021): 16–21. http://dx.doi.org/10.3329/birdem.v12i1.57220.
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Background: Guillain-Barre syndrome (GBS) is an acute, frequently severe and fulminant polyradiculoneuropathy that is autoimmune in nature. Incidence and predominant subtypes of GBS differ geographically. Electrophysiology has important role in subtyping GBS. This study aimed to evaluate the electrophysiological findings in patient of GBS.
 Methods: This was a hospital based cross-sectional descriptive study and conducted at the Department of Neurology in Sir Salimullah Medical College & Mitford Hospital, Dhaka and National Institute of Neurosciences and Hospital, Dhaka during July 2017 to June 2018. Clinically diagnosed 53 patients with GBS were enrolled according to prefixed selection criteria. Detail history taking, clinical examination, nerve conduction study and cerebrospinal fluid (CSF) examination was performed in all cases. Clinical findings, nerve conduction study (NCS) parameters, CSF findings and demographic profiles were evaluated.
 Results: Mean ± SD age of presentation was 41.64 (±14.56) years and median age was 42.0 years. There were total 33(62 %) males and 20 (38 %) females with male: female ratio of 1.7:1. Clinically two-thirds(62.3%) of patients had both upper and lower limb involvement (62.3%), facial weakness was in 32.1% and 13.2% had bulbar involvement. Acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN)were found to be 51%, 32% and 17% respectively. CSFprotein was elevated in most of the patients with a range of 16-725 mg/dl. Highest CSF protein was found in AIDP.
 Conclusion: Electrophysiological studies play an important role in the early detection; characterization of GBS.In this study, the commonest type of GBS was AIDP. Higher levels of CSF protein, absent H-reflex and Fresponse, sural sparing and unexcitable nerves are more frequently present in AIDP.
 BIRDEM Med J 2022; 12(1): 16-21
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Siekierko, Nikola, Maja Żołnierek, Wiktoria Kotusiewicz, et al. "Guillain-Barre Syndrome linked to SARS-CoV-2 infection – meta-analysis and literature review." Journal of Education, Health and Sport 25, no. 1 (2023): 40–56. http://dx.doi.org/10.12775/jehs.2023.25.01.004.
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Background
 The novel coronavirus disease-2019 (COVID-19), which is caused by Severe Acute Respiratory Distress Syndrome coronavirus 2 (SARS-CoV2), was originally detected in Wuhan, China in December 2019. In this meta-analysis and literature review, we compared and summarized the clinical presentation, cerebrospinal fluid (CSF) and electromyography (EMG) findings and outcomes in SARS-CoV-2 patients with Guillain-Barre Syndrome (GBS) and its variants.
 Methods
 We conducted a literature review in February 2023 searching for terms “Guillain-Barre Syndrome and COVID-19", “SARS neurology”, “COVID-19 complications”. We used PubMed and Google Scholar databases inquiring case reports or series of cases published between April 1, 2020, and September 14, 2023.
 Results
 Of the 52 GBS cases 61,5% (n=32) were male and 39,5% (n=20) were female. The mean age was 57 years old. A total of 75% (n=33) patients presented acute inflammatory demyelinating polyneuropathy (AIDP) variant, 6,8% (n=3) presented acute motor axonal neuropathy (AMAN) variant, 15,9% (n=7) presented acute motor-sensory axonal neuropathy (AMSAN) variant. A total of 85,7% (n=42) of patients were diagnosed with albuminocytological dissociation. During the hospitalization, a total of 30,8% (n=16) required mechanical ventilation. A total of 61,5% (n=32) of patients were treated with a 5-day regimen of intravenous immunoglobulin (IVIG) in dose 0.4 g/kg/day. There were 46,1% (n=24) complete recoveries from GBS, 32,7% (n=17) partial recoveries and 9,6% (n=5) of patients did not respond to treatment. A total of 11,5% (n=6) of patients died.
 Conclusion
 It is crucial to follow patients with COVID-19 and GBS over time to estimate properly the efficacy of treatment and evaluate the real percentage of recovery and complications.
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Kumar, Mritunjai, Ashutosh Tiwari, Shakti Kumar, and Rajni Singh. "Dose–Effect Relationship of Motor Nerve Inexcitability on Outcome in Guillain–Barré Syndrome: A Prospective Cohort Study." Annals of Indian Academy of Neurology 26, no. 6 (2023): 936–42. http://dx.doi.org/10.4103/aian.aian_641_23.
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Objective: One or more inexcitable motor (IM) nerves are common during electrodiagnostic (EDx) study in Guillain–Barré syndrome (GBS). This study assessed the dose–effect relationship of IM nerves on outcome in patients with acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor and/or sensory axonal neuropathy (AMAN and AMSAN). Materials and Methods: Eighty-eight GBS patients admitted during May 2018–June 2023 underwent detailed clinical evaluation and EDx study. Admission and follow-up disability were assessed on a 0–10 Clinical Grading Scale (CGS). Outcome was recovery at 6 months, defined as good (CGS <3) and poor (CGS ≥3). Binary multivariate logistic regression with backward elimination was used to calculate independent predictors of outcome. Results: Proportion of patients with complete recovery decreased significantly with increasing numbers of IM nerves (P < 0.01). Seventy-six patients were followed for 6 months. Among patients with IM nerves (n = 28), complete recovery was similar between AIDP and axonal GBS (70% vs. 50%, respectively; P = 0.40). However, in patients with recordable compound muscle action potentials (CMAPs) in all the motor nerves (n = 26), axonal GBS had significantly poor recovery compared to AIDP (75% vs. 9.1%; P = 0.01). Among patients receiving intravenous immunoglobulin (IVIg; n = 42), poor recovery was seen in 53.6% with IM nerves compared to 35.7% without (P = 0.28), while it was 37.5% versus 5.6% (P = 0.04), respectively, in those who did not receive IVIg (n = 34). However, only admission disability (odds ratio [OR] 0.88, 95% confidence interval [CI] 0.81–0.97; P = 0.007) was found to be an independent predictor of outcome. Conclusion: Although increasing numbers of IM nerves were associated with poor outcome on univariate analysis, they did not predict 6 months’ outcome independently. Outcome did not differ between axonal GBS and AIDP among those with IM nerves. IVIg improved outcome in patients with IM nerves.
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Stojkovic, Jasna, Ivana Petronic, Dejan Nikolic, Sinisa Ducic, Goran Vrgoc, and Bojan Bukva. "Severe painful lower limbs and refusal of the leg reliance as atypical presentation of Gullain Barre syndrome." Srpski arhiv za celokupno lekarstvo 147, no. 11-12 (2019): 755–57. http://dx.doi.org/10.2298/sarh180710044s.
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Introduction. Guillain?Barre syndrome (GBS) is the most common cause of acute flaccid paralysis in healthy infants and children. Acute motor axonal neuropathy (AMAN) is a type of GBS characterized by motor syndrome with no sensory symptoms. Case outline. Authors describe a six-and-a-half year old girl with atypical clinical presentation of AMAN with severe painful lower limbs and refusal of the leg reliance with typical findings on nerves conduction studies. Conclusion. Despite the nerve conduction study findings, atypical forms of AMAN and GBS are possible. Pain symptoms must be taken very seriously and treated careful by the clinicians.
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Mallick, Uzzwal Kumar, Mohammad Shah Jahirul Hoque Chowdhury, Mohammad Enayet Hussain, et al. "Comparison of ICU Outcomes between Intravenous Immunoglobulin and Plasma Exchange in Treatment of Mechanically Ventilated Patients with GuillainBarré Syndrome in a Neuro-Intensive Care Unit in a Govt. Hospital of Bangladesh: A Observational Cohort Study." Journal of National Institute of Neurosciences Bangladesh 5, no. 2 (2019): 118–22. http://dx.doi.org/10.3329/jninb.v5i2.43015.
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Background: The management of Guillain-Barré Syndrome is very crucial for the outcome of the patient.
 Objective: The aim of the study was to compare efficacy of IvIg(Intravenous Immunoglobulin) versus PE(Plasmaexchange) in treatment of mechanically ventilation adults with GBS in neuro-intensive care unit of Bangladesh.
 Methodology: Thiswas a prospective, observationalcohort study, in a Neuro-ICU from 2017 to 2018. We included all patients with GBS who required mechanical ventilation (MV). We defined two groups: group 1 (group treated by IvIg: 0.4 g/kg/day for 5 days) and group 2 (group treated by PE: 5 PE during 10days, every alternate day). We collectedclinical and therapeutic aspects and outcome.
 Results: A total number of 49 patients (34 in group 1 and 15 in group 2) were enrolled. The mean age was 37.4±9.2 years, with a male predominance (65.3%). on electrophysiological findings, in 4(32.7%) patients had acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy (AMAN) in 26 (53.1%) patients and acute motor-sensory axonal neuropathy (AMSAN) was 3(6.1%)and NCS was not done in 4(8.2%) cases. The mean length of ICU stay was 20±19.10 days and 46.60±30.02 days in IVIG and PE group respectively. The ICU stay was significantly shorter (p = 0.001) in the IvIg group than PE group. Patients receiving IvIg were early weaned of MV (p = 0.002) compared to those receiving PE with a statistical significance. Also, duration of M/V (P=.002), Need of tracheostomy (p=.005) and over all surval rate (p=.007) was significantly in favoue of IvIg group than PE group. Out of 49 patients, total 3 patients were died and they all were AMAN variety.
 Conclusion: Our work reveals a meaningful difference for the MV duration, ICU stay, weaning and excellent recovery in IvIg group compared to PE group in terms of less complcations.
 Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 118-122
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Sekiguchi, Yukari, Sonoko Misawa, Tomoki Suichi, Hiroshi Amino, Minako Beppu, and Satoshi Kuwabara. "O-3-02. The Involvement of sensory fibers in acute motor axonal neuropathy (AMAN)." Clinical Neurophysiology 129, no. 5 (2018): e35. http://dx.doi.org/10.1016/j.clinph.2018.02.087.
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Rostásy, K. M., P. Huppke, B. Beckers, et al. "Acute Motor and Sensory Axonal Neuropathy (AMSAN) in a 15-Year-Old Boy Presenting with Severe Pain and Distal Muscle Weakness." Neuropediatrics 36, no. 4 (2005): 260–64. http://dx.doi.org/10.1055/s-2005-865774.
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Voitenkov, Vladislav B., Natalia V. Skripchenko, Andrey V. Klimkin, and Stepan G. Grigoriyev. "Neurophysiology of Guillain-Barré syndrome in children." Pediatrician (St. Petersburg) 9, no. 4 (2018): 50–57. http://dx.doi.org/10.17816/ped9450-57.
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Our aim was to evaluate sensitivity and specificity of conduction studies parameters for prognosis and differential diag nosis in children with acute motor axonal neuropathy (AMAN) & acute inflammatory demyelinating polyneuropathy (AIDP).
 Methods. 40 children were included: 20 healthy controls (7-14 years) and 20 patients (8-15 years) with AIDP or AMAN. All underwent conduction studies on 3-7 day since the clinical symptoms onset. We registered and evaluated motor conduction velocity, compound muscle action potential (CMAP) amplitude of nn. tibialis, peroneus, medianus, ulnaris; sensory conduction velocity & sensory nerve action potential (SNAP) amplitude for nn. medianus, suralis, peroneus superficialis, ulnaris, H-reflex threshold & latency, reactivity of neural conductivity (RNC) in short-term hand ischemia in acute phase (3-14 day since the disease onset) and in early recovery period (15-30 day since the symptoms onset). ROC-analysis was performed.
 Results. In 95% of the patients with Guillain-Barré syndrome H-reflex was absent. In first 10 days SNAP amplitude of median nerve >8.9 µV, peroneal nerve >3.6 µV, CMAP of peroneal nerve ≤0,4 µV with normal motor conduction velocity indicates AMAN presence. Motor axons of peripheral nerves in children in acute and recovery phase of AIDP are resistant towards ischemia. Prognostic criteria for long period of walk recovery (more than 30 days) in these patients are RNC on 10th minute of local ischemia ≤2.5%, ulnar nerve CMAP amplitude ≤1,1 mV and distal CMAP amplitude from median nerve ≤1.6 mV.
 Conclusions. Conduction studies may be implemented on all phases of Guillain-Barré syndrome in children for prognosis and differential diagnosis between its axonal and demyelinating forms. H-reflex absence in children in the first 5 days of acute polyneuropathy may serve as additional diagnostic criteria for Guillain-Barré syndrome. RNC parameters may be implemented for the prognosis of the walk period recovery duration.
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Mahajan, Roopali, Jayantee Kalita, Vishal Jha, Nagendra B. Gutti, Prakash C. Pandey, and Usha K. Misra. "Temporal Pattern of Individual Neurological Function Recovery in Guillain–Barré Syndrome." Journal of Clinical Medicine 13, no. 18 (2024): 5635. http://dx.doi.org/10.3390/jcm13185635.
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Background: There is paucity of studies on the temporal pattern of recovery of facial, bulbar, sensory, motor, and autonomic dysfunction in Guillain–Barré syndrome (GBS), although many studies have reported short- and long-term functional outcomes. We report the temporal pattern of recovery of various neurological functions in GBS, and compare the pattern of recovery between acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy (AMAN). Methods: Forty-two patients with GBS were prospectively included, and their clinical details, including peak disability on a 0–6 scale, were noted. The day of complete recovery in motor, sensory, facial, bulbar, and autonomic functions during 3 months of follow-up was recorded. Results: Complete recovery of autonomic function occurred in all (median, 12 days), bulbar weakness in 91.3% (median, 15 days), facial weakness in 86.2% (median, 19 days), and sensory functions in 82.1% (median, 20 days). Only 9.5% of patients achieved normal motor function within 3 months. The days of complete recovery of bulbar, facial, autonomic, and motor deficits were comparable between AIDP and AMAN. Demyelinating GBS had an earlier recovery of bulbar and sensory functions. Conclusions: The neurological recovery in GBS occurs first in the autonomic, followed by the bulbar, facial, sensory, and motor functions. The demyelinating type had an earlier recovery of bulbar and sensory functions.
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Laksmitasari, Budiati, Johanes Putra, Luh Karunia Wahyuni, and Rizky Kusuma Wardhani. "Rehabilitation of A Child with Low Endurance in the Recovery Phase of Guillain-Barré Syndrome." Medica Hospitalia : Journal of Clinical Medicine 11, no. 1 (2024): 113–18. http://dx.doi.org/10.36408/mhjcm.v11i1.1020.
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BACKGROUND: Guillain-Barré Syndrome (GBS) usually has a good prognosis of recovery. However, some patients can have remaining disabilities due to low cardiorespiratory fitness or endurance and needs to be managed. AIMS: This study reports the rehabilitation assessment and management of a child with low cardiorespiratory endurance in the recovery phase of GBS. CASE: A 12-year-old girl with a history of hospitalization due to Acute Motor and Sensory Axonal Neuropathy (AMSAN)-type of GBS was referred to the Physical Medicine and Rehabilitation (PMR) outpatient clinic with tiredness that restricted her school participation. She had low cardiorespiratory endurance, which was confirmed by a six-minute walk test (6-MWT). After the rehabilitation program, her endurance level was increased, and she can return to school. DISCUSSION: A comprehensive assessment showed that the muscle weakness, accompanied by obesity, anemia, and inactivity, led to low cardiorespiratory endurance that restricted the activity and participation. A rehabilitation program that consisted of aerobic and strengthening exercises improved cardiorespiratory endurance, walking ability, and school participation. CONCLUSION: Rehabilitation management in children with low cardiorespiratory endurance due to the sub-acute phase of GBS could help them regain their activity and participation during the recovery phase.
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Jamshaid Iqbal, Abdul Hameed Khan, Sarah Azam, et al. "OUTCOME OF PLEX IN GUILLAIN–BARRÉ SYNDROME PATIENTS TREATED BEFORE AND AFTER 7 DAYS OF SYMPTOMS ONSET." Insights-Journal of Health and Rehabilitation 2, no. 2 (Health & Rehab) (2024): 209–14. https://doi.org/10.71000/ijhr137.
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Background: Guillain-Barré Syndrome (GBS) is an acute, immune-mediated polyneuropathy that often follows infections, characterized by varying degrees of motor weakness, sensory impairment, and autonomic dysfunction. The disease has multiple subtypes, including Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) and Acute Motor Axonal Neuropathy (AMAN), with diverse functional outcomes. Plasma exchange (PLEX) has emerged as a cost-effective and efficient therapeutic option in resource-limited settings, but its impact on various subtypes and functional outcomes requires further exploration. Objective: To evaluate the effectiveness of plasma exchange (PLEX) as a treatment for GBS and to prospectively analyze the clinical and functional outcomes of patients aged 16 and above across different subtypes of GBS. Methods: This prospective observational study was conducted over six months at a tertiary care hospital in Rawalpindi. Participants aged 16 and older, meeting inclusion criteria, underwent detailed history taking, clinical examination, and electrophysiological studies, including Forced Vital Capacity (FVC) and EMG, to categorize GBS subtypes. Functional disability was assessed using the Hughes GBS Disability Scale. All patients received five sessions of PLEX initiated on the day of admission. Outcomes were evaluated on the seventh day. Data analysis was performed using SPSS, with quantitative variables presented as means and qualitative variables as percentages. Results: A total of 40 participants were included, with a mean age of 38.97 ± 5.4 years. Males constituted 63% (n = 25) and females 37% (n = 15). Participants were categorized by Hughes GBS Disability Score into Group 1 (n = 5, Score 2), Group 2 (n = 12, Score 3), Group 3 (n = 20, Score 4), and Group 4 (n = 3, Score 5). Based on EMG findings, 57.5% (n = 23) had AIDP, 30% (n = 12) had AMAN, and 12.5% (n = 5) had AMSAN. After seven days of treatment, 80% of patients in Groups 1 and 2 showed significant improvement, while 75% in Group 3 and 33% in Group 4 demonstrated partial recovery. AIDP had the best response to PLEX, with 24 patients showing improvement, compared to 1 patient with AMAN and 2 with AMSAN. Conclusion: Patients with GBS exhibit varying functional disabilities and outcomes across different subtypes. PLEX demonstrated significant improvement, particularly in patients with lower initial disability scores and the AIDP subtype. Early intervention and subtype-specific management are critical for optimizing outcomes.
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Dr., Fatima Dilshad Dr Khadija Sarwar Dr Sundas Zafar. "STUDY TO KNOW THE ACUTE FLACCID PARALYSIS CLINICAL PRESENTATION ELECTROPHYSIOLOGIC SUB TYPES OF GBS AND ITS SEASONAL VARIATIONS." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES o6, no. 06 (2019): 13037–41. https://doi.org/10.5281/zenodo.3257124.
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<em>Acute flaccid paralysis (AFP) is a clinical syndrome determined by a prompt onset of weakness, often involving bulbar and respiratory weakness. Early and accurate diagnosis of the cause has a significant impact on the prognosis and management. Guillian Barre syndrome (GBS) is post-infectious polyradiculoneuropathy, which mostly affects the motor, but sometimes affects autonomic and sensory nervous system.</em> <strong><em>Objective:</em></strong><em> To determine the acute flaccid paralysis clinical presentations, electrophysiologic subtypes of GBS, their outcome and seasonal variations in our setup. </em> <strong><em>Study Design:</em></strong><em> A Retrospective Study.</em> <strong><em>Place And Duration:</em></strong><em> In the Department of Neurology, Combined Military Hospital (CMH), Lahore for one year duration from September 2017 to September 2018.</em> <strong><em>Methods:</em></strong><em> Retrospective and hospital studies were performed in the department of Neurology to determine the clinical characteristics of GBS including current treatment methods and outcomes, and prognosis of disease severity. Diagnostic features include paresis, flaccid paralysis or weakness of limb with or without autonomic symptoms or sensory symptoms, albino-cytological dissociation, nerve conduction rate (NCV), laboratory properties such as ECG, serum electrolytes and MRI.</em> <strong><em>Results:</em></strong><em> In this study; 55 patients were included for 1 year duration. Of these, 29 (53%) had GBS, hypokalemic periodic paralysis in 21 (38%) and idiopathic neuropathy in 5 (9%). NCV test was applied to all and categorized as 18 patients ha AIDP (acute inflammatory demyelinating polyneuropathy, 8 patients had AMAN (acute motor axonal neuropathy) and 3 patients had AMASAN (acute motor and sensory axonal neuropathy. Most of the patients presented symmetrically elevated paralysis, gradually progressing in all extremities. In our study, the rate of males was affected by more females: 1.63: 1 and in spring and winter season; 23 patients presented. During the 2nd and 3rd decade there was mild increase age range and in the 5th decade, the second peak was seen. Ten percent of the patients has recurrence in five years. URTI, pneumonia, sore throat, diarrhea in most of the related diseases. The most common cranial nerve involvement was the paralysis of the facial nerve. The majority improved only with supportive therapy, ventilator support was needed in 11% of patients and 22% indicated IVIG or plasmapheresis. Almost half of the patients completely recovered at 3 months of follow-up and improved at follow-up.</em> <strong><em>Conclusion:</em></strong><em> Timely treatment and diagnosis is necessary to support and manage these treatable diseases. Adequate training, psychological support and physiotherapy are mandatory.</em> <strong>Key words:</strong> <em>Hypokalemic periodic paralysis, acute flaccid paralysis, GBS, AIDP, AMASAN, AMAN.</em>
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Sulfana Putri, Elsa Primadona, Idzni Mardhiyah, and Sri Wahyu Evianti. "Guillain-Barre Syndrome Associated with Disseminated Tuberculosis: A Case Report." Magna Neurologica 3, no. 2 (2025): 87–92. https://doi.org/10.20961/magnaneurologica.v3i2.2270.
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Background: Guillain-Barre syndrome (GBS) is a life-threatening, acute, immune-mediated polyneuropathy associated with preceding infections. Tuberculosis (TB), although it has a high incidence rate, is rarely reported to be associated with GBS. Case: We report the case of a 20-year-old female admitted to our hospital with a progressive symmetrical paraparesis, which further developed to paraplegia, along with a month-long history of constitutional symptoms. After investigation, the patient was diagnosed with an acute motor and sensory axonal neuropathy (AMSAN) variant of GBS and disseminated TB. The patient was treated with plasmapheresis, and first-line anti-tuberculosis therapy was initiated. The patient demonstrated significant improvement in muscle strength in response to the treatment. The pathogenesis of GBS in TB is believed to be due to molecular mimicry, leading to nerve damage or direct invasion of the nerve root by tubercular bacilli. Discussion: Guillain-Barre syndrome could be induced by tuberculosis, and treatment for both could improve the outcome. Thus, early diagnosis is critical. Further investigations must be conducted to understand the association of GBS and TB. Conclusion: Guillain-Barre syndrome could be induced by tuberculosis, and treatment for both could improve the outcome. Thus, early diagnosis is critical. Further investigations must be conducted to understand the association of GBS and TB.
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SIEKIERKO, Nikola, Maja ŻOŁNIEREK, Wiktoria KOTUSIEWICZ, et al. "Guillain-Barre Syndrome linked to SARS-CoV-2 infection – meta-analysis and literature review." Journal of Education, Health and Sport 25, no. 1 (2023): 40–56. https://doi.org/10.12775/JEHS.2023.25.01.004.
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<strong>SIEKIERKO, Nikola, ŻOŁNIEREK, Maja, KOTUSIEWICZ, Wiktoria, LEWANDOWSKI, Mateusz, BIENIA, Grzegorz, LUBCZYŃSKA, Zuzanna, POPRAVKO, Yevheniia & ŚWIĘTOCHOWSKI, Jakub. Guillain-Barre Syndrome linked to SARS-CoV-2 infection – meta-analysis and literature review.</strong> <strong>Journal of Education, Health and Sport. 2023;</strong><strong>25</strong><strong>(1):</strong><strong>40-56</strong><strong>. eISSN 2391-8306. DOI </strong><strong>http://dx.doi.org/10.12775/JEHS.2023.25.01.00</strong><strong>4</strong> <strong>https://apcz.umk.pl/JEHS/article/view/435</strong><strong>63</strong> <strong>https://zenodo.org/record/7886506</strong> <strong>The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32343.</strong> <strong>Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences).</strong> <strong>Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159.</strong> <strong>Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu).</strong> <strong>© The Authors 2023;</strong> <strong>This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland</strong> <strong>Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike.</strong> <strong>(http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited.</strong> <strong>The authors declare that there is no conflict of interests regarding the publication of this paper.</strong> <strong>Received: </strong><strong>13</strong><strong>.</strong><strong>04.</strong><strong>2023. Revised: </strong><strong>20</strong><strong>.0</strong><strong>4</strong><strong>.2023. Accepted: </strong><strong>02</strong><strong>.0</strong><strong>5</strong><strong>.2023. Published: </strong><strong>02</strong><strong>.0</strong><strong>5</strong><strong>.2023.</strong> <strong>Guillain-Barre Syndrome linked to SARS-CoV-2 infection</strong> <strong> – meta-analysis and literature review</strong> Nikola Siekierko Szpital Praski pw. Przemienienia Pańskiego https://orcid.org/0000-0002-1113-7112 Maja Żołnierek Samodzielny Publiczny Specjalistyczny Szpital Zachodni im. św. Jana Pawła II https://orcid.org/0000-0002-4860-2508 Wiktoria Kotusiewicz Wojskowy Instytut Medyczny- Państwowy Instytut Badawczy https://orcid.org/0000-0003-4033-0648 Mateusz Lewandowski UNIVERSITY CLINICAL CENTER OF WARSAW MEDICAL UNIVERSITY https://orcid.org/0000-0002-4968-1770 Grzegorz Bienia Military Institute of Medicine-National Research Institute https://orcid.org/0000-0001-9036-5510 Zuzanna Lubczyńska Szpital Grochowski im. dr med. Rafała Masztaka https://orcid.org/0000-0002-4860-2508 Yevheniia Popravko Szpital Praski pw. Przemienienia Pańskiego https://orcid.org/0000-0002-1164-1802 Jakub Świętochowski Uniwersyteckie Centrum Kliniczne w Gdańsku https://orcid.org/0000-0003-3848-6520 <strong>Abstract</strong> <strong>Background</strong> The novel coronavirus disease-2019 (COVID-19), which is caused by Severe Acute Respiratory Distress Syndrome coronavirus 2 (SARS-CoV2), was originally detected in Wuhan, China in December 2019. In this meta-analysis and literature review, we compared and summarized the clinical presentation, cerebrospinal fluid (CSF) and electromyography (EMG) findings and outcomes in SARS-CoV-2 patients with Guillain-Barre Syndrome (GBS) and its variants. <strong>Methods</strong> We conducted a literature review in February 2023 searching for terms “Guillain-Barre Syndrome and COVID-19", “SARS neurology”, “COVID-19 complications”. We used PubMed and Google Scholar databases inquiring case reports or series of cases published between April 1, 2020, and September 14, 2023. <strong>Results</strong> Of the 52 GBS cases 61,5% (n=32) were male and 39,5% (n=20) were female. The mean age was 57 years old. A total of 75% (n=33) patients presented acute inflammatory demyelinating polyneuropathy (AIDP) variant, 6,8% (n=3) presented acute motor axonal neuropathy (AMAN) variant, 15,9% (n=7) presented acute motor-sensory axonal neuropathy (AMSAN) variant. A total of 85,7% (n=42) of patients were diagnosed with albuminocytological dissociation. During the hospitalization, a total of 30,8% (n=16) required mechanical ventilation. A total of 61,5% (n=32) of patients were treated with a 5-day regimen of intravenous immunoglobulin (IVIG) in dose 0.4 g/kg/day. There were 46,1% (n=24) complete recoveries from GBS, 32,7% (n=17) partial recoveries and 9,6% (n=5) of patients did not respond to treatment. A total of 11,5% (n=6) of patients died. <strong>Conclusion</strong> It is crucial to follow patients with COVID-19 and GBS over time to estimate properly the efficacy of treatment and evaluate the real percentage of recovery and complications. <strong>Keywords</strong>: AIDP, AMSAN, COVID-19, GBS, SARS-CoV-2 <strong>Abstrakt</strong> <strong>Wprowadzenie</strong> Nowa choroba COVID-19, wywoływana przez drugi koronawirus ciężkiego ostrego zespołu oddechowego (SARS-CoV2), została pierwotnie wykryta w miejscowości Wuhan w Chinach w grudniu 2019 roku. W tej metaanalizie i przeglądzie literatury porównano i podsumowywano obraz kliniczny oraz wyniki badania płynu mózgowo-rdzeniowego (CSF) i elektromiografii (EMG) u pacjentów z współistniejącym zakażeniem SARS-CoV-2 z zespołem Guillaina-Barrego (GBS) i jego wariantami. <strong>Metody przeglądu</strong> W lutym 2023 roku przeprowadzono przegląd literatury wyszukując następujące słowa kluczowe: „Zespół Guillaina-Barrego i COVID-19’, „SARS neurologia”, „powikłania COVID-19”. W tym celu użyto bazy danych PubMed i Google Scholar rozpatrując opisy przypadków opublikowanych między 1 kwietnia 2020 roku a 14 września 2023 roku. <strong>Wyniki</strong> Z 52 przypadków GBS 61,5% (n=32) stanowili mężczyźni, a 39,5% (n=20) kobiety. Średnia wieku wynosiła 57 lat. Łącznie u 75% (n=33) pacjentów wystąpił wariant ostrej demielinizacyjnej polineuropatii zapalnej(AIDP), u 6,8% (n=3) wariant ostrej ruchowej neuropatii aksonalnej (AMAN), u 15,9% (n=7) wariant ostrej ruchowo-czuciowej neuropatii aksonalnej (AMSAN). Łącznie u 85,7% (n=42) pacjentów rozpoznano rozszczepienie komórkowo-białkowe. W trakcie hospitalizacji 30,8% (n=16) pacjentów wymagało wentylacji mechanicznej. 61,5% (n=32) pacjentów otrzymało 5-dniowy schemat dożylnej immunoglobuliny (IVIG) w dawce 0,4 g/kg mc./dobę. 46,1% (n=24) całkowicie wyzdrowiało z GBS, 32,7% (n=17) wyleczyło się częściowo, a 9,6% (n=5) pacjentów nie odpowiedziało na leczenie. Łącznie zmarło 11,5% (n=6) pacjentów. <strong>Wnioski</strong> Kluczowym jest obserwowanie pacjentów z współistniejącym zakażeniem SARS-CoV-2 z zespołem Guillaina-Barrego (GBS) aby prawidłowo oszacować skuteczność leczenia i ocenić rzeczywisty procent wyzdrowień i powikłań. <strong>Słowa kluczowe: </strong>AIDP, AMSAN, COVID-19, GBS, SARS-CoV-2 <strong>Abbreviations</strong>: AIDP, Acute inflammatory demyelinating polyneuropathy; AMSAN, Acute motor-sensory axonal neuropathy; AMAN, Acute motor axonal neuropathy; CoV, coronavirus; COVID-19, novel coronavirus disease-2019; COVID-19, Coronavirus infectious disease-2019; GBS, Guillain-Barre Syndrome; SARS-CoV-2, Severe Acute Respiratory Distress Syndrome coronavirus 2; PE, plasmapheresis; IVIG, Intravenous immunoglobulin; IL, Interleukin; EMG, Electromyography; CSF, Cerebrospinal fluid; RT-PCR, Reverse transcriptase polymerase chain reaction; WHO;, World Health Organization; SARS, severe acute respiratory distress syndrome; MERS, Middle East respiratory syndrome
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Gniadek-Olejniczak, Katarzyna, Kazimierz Tomczykiewicz, Katarzyna Joźwik-Plebanek, Adam Stępień, Ewa Ungier, and Jozef Mroz. "Guillan-Barre syndrome or only a peripheral nervous system disease? Case Report." Acta Balneologica 66, no. 6 (2024): 410–14. https://doi.org/10.36740/abal202406107.
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Acute Motor Sensory Axonal Neuropathy (AMSAN) is a variation of Guillain-Barre syndrome (GBS). It is characterized by a severe clinical course generating, in up to 20% of patients, permanent neurological deficits. We are presenting a case of a 45-year-old female patient with a severe clinical course, with a diagnosis of AMSAN with record high protein values in the cerebrospinal fluid. A week prior to the hospital admission, the patient was treated for upper respiratory tract infection. Two days prior to hospitalization, she began to experience ascending paraesthesia in the region of lower extremities. A nerve-conduction study showed extension of latency or absence of the F wave. Irregularities in the form of short ictal discharges were also observed in the ECG tracings. From the fourth day of hospitalization, the patient’s neurological condition began to deteriorate progressing towards flaccid quadriplegia with cranial nerves involvement and symptoms of ‘vegetative storm’. Following three-week hospitalization and treatment instituted, the overall and neurological condition of the patient began to stabilize and gradually improve. The patient was transferred to rehabilitation units where she spent a total of 12 months. Home rehabilitation was completed at two years from the development of the disease with full restoration of mobility. The described course of the disease with ECG changes is but another single report confirming that CBS is not only only and solely a disease of the peripheral nervous system.
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Sanjeev, Kumar Singh, Gupta Veena, Kumar Ashwani, and Sharma Sudhir. "A Clinical and Demographic Profile of Tertiary Care Patients with Guillain-Barré Syndrome in Himachal Pradesh." International Journal of Pharmaceutical and Clinical Research 14, no. 9 (2022): 201–10. https://doi.org/10.5281/zenodo.13324096.
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Guillain-Barré syndrome (GBS) is a complex disorder characterized by immune-mediated, self-limiting, reactive peripheral neuropathies. GBS can produce life-threatening problems if it affects the breathing muscles or the autonomic nervous system. The present study was done to see the clinical profile and the epidemiological trends occurring among 30 diagnosed patients reported over a one-year duration during their hospital stay. Patients with Guillain-Barre Syndrome (GBS) were diagnosed using the Asbury and Cornblath criteria for case definition of GBS, as well as supporting laboratory and electrodiagnostic findings. A total of 30 cases were diagnosed, F: M ratio of the case was 1:1.3. The age range of the case was 19-80 years. The maximum number of cases was in the 31 to 40 years (n=7) age range. Maximum cases were reported from July to September (43.33 percent) during the summer and rainy seasons, whereas there were no reported cases from October to December. 80 percent (n=24) of cases were reported within the first week, 16.67 percent (n=5) during the second week, and only 3.33 percent (n=1) during the third week. There was a history of previous illness in the form of loose stools, fever, and respiratory tract infection, as well as other GI infections, in 46.67% of cases, the most prevalent of which was loose stools with fever in 30% of cases.In 24 cases, weakness was present in both the upper and lower limbs, whereas in 6 cases, weakness was predominant in the lower limb. In six cases, facial weakness was also present. The most frequently reported sensory symptom was numbness, followed by a tingling sensation and a burning sensation. Almost all the cases had areflexia, either total areflexia (14 out of 30 or 46.67%) or partial areflexia (16 out of 30 or 53.33%), with the majority lacking knee and ankle reflexes.