RE: Guillain-Barre Syndrome Related to COVID-19 Infection. Comments after 16 published cases
CristinaGuijarro-Castro, Neurologist. School of Medicine Professor, CINAC Puerta del Sur
Submitted May 20, 2020
We read with interest the paper by Alberti et al.1 We want to comment on a similar Guillain- Barré Syndrome (GBS) case following bilateral SARS-CoV2 pneumonia and to highlight the evolution of post-infectious GBS.
On May 4th, 2020, a 70-year-old man presented with progressive weakness of all limbs of 5 days of progression, after SARS-CoV-2 infection two weeks before.
Neurologic examination showed asymmetric weakness (Medical Research Council grade 4/5, right hand; 4+/5, left hand; 4/5, left leg and 3+/5, right leg) and areflexia in both legs and feet. Nerve conduction studies (day 6) exhibited delayed distal latencies and absent F waves in early course and albumin-cytological dissociation in CSF. He was diagnosed with GBS and IV immunoglobulins (0.4 g/kg/d for 5 days) were started 8 hours after admission. He evolved favorably and was discharged with minimum deficit.
To date and to our knowledge, three prior cases of GBS concomitant with SARS-CoV-2 infection and a parainfectious profile have been reported1,2,3 and thirteen after SARS-CoV-2 infection2,4 (Table 1). These cases support a causal relationship with SARS-CoV-2 infection.
The Spanish Society of Neurology develops a multicenter nationwide observational study on neurologic presentations and complications of COVID-19.
We read with interest the paper by Alberti et al.1 We want to comment on a similar Guillain- Barré Syndrome (GBS) case following bilateral SARS-CoV2 pneumonia and to highlight the evolution of post-infectious GBS.
On May 4th, 2020, a 70-year-old man presented with progressive weakness of all limbs of 5 days of progression, after SARS-CoV-2 infection two weeks before.
Neurologic examination showed asymmetric weakness (Medical Research Council grade 4/5, right hand; 4+/5, left hand; 4/5, left leg and 3+/5, right leg) and areflexia in both legs and feet. Nerve conduction studies (day 6) exhibited delayed distal latencies and absent F waves in early course and albumin-cytological dissociation in CSF. He was diagnosed with GBS and IV immunoglobulins (0.4 g/kg/d for 5 days) were started 8 hours after admission. He evolved favorably and was discharged with minimum deficit.
To date and to our knowledge, three prior cases of GBS concomitant with SARS-CoV-2 infection and a parainfectious profile have been reported1,2,3 and thirteen after SARS-CoV-2 infection2,4 (Table 1). These cases support a causal relationship with SARS-CoV-2 infection.
The Spanish Society of Neurology develops a multicenter nationwide observational study on neurologic presentations and complications of COVID-19.
Disclosure
For disclosures, please contact the editorial office at journal@neurology.org.
References