Case Report: Intracranial Hypertension Secondary to Guillain-Barre Syndrome

Doxaki, Christina; Papadopoulou, Eleftheria; Maniadaki, Iliana; Tsakalis, Nikolaos G; Palikaras, Konstantinos; Vorgia, Pelagia

doi:10.3389/fped.2020.608695

Cited by 10 publications

(7 citation statements)

References 59 publications

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“…In a systematic review of 27 cases reports of GBS with documented raised ICP, 16 patients had papilloedema 15. The onset of raised ICP during the disease course varied.…”

Section: Discussionmentioning

confidence: 99%

Severe papilloedema with vision loss secondary to Guillain-Barré syndrome

Moloney,

Ong,

Irani

2024

BMJ Case Rep

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We discuss a patient who presented with bilateral VI and VII cranial nerve palsies, symmetric upper and lower limb weakness and areflexia, 2 weeks following an flu-like illness. At presentation, there was no papilloedema, and her visual function was normal. Cerebrospinal fluid analysis and electrophysiology supported the diagnosis of Guillain-Barré Syndrome (GBS). She received intravenous immunoglobulins. She subsequently developed headaches and vision loss. Funduscopy demonstrated severe papilloedema with visual acuity of 6/18 right eye, 6/12 left eye with bitemporal visual field depression. Lumbar puncture revealed elevated opening pressure with high protein and normal cell count. She received acetazolamide. There was resolution of papilloedema and normal visual function at 3 months. Of note, the patient’s body mass index was 17 kg/m2.Our case highlights the rare occurrence of papilloedema in GBS, reiterating the importance of performing funduscopy on patients with any neurological diagnosis. Early detection and prompt management of papilloedema can prevent permanent vision loss.

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“…In a systematic review of 27 cases reports of GBS with documented raised ICP, 16 patients had papilloedema 15. The onset of raised ICP during the disease course varied.…”

Section: Discussionmentioning

confidence: 99%

Severe papilloedema with vision loss secondary to Guillain-Barré syndrome

Moloney,

Ong,

Irani

2024

BMJ Case Rep

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“…In addition to post-infectious ON, some other etiologies are also responsible for visual impairment complicating with GBS, such as increased intracranial pressure [ 6 ] and posterior reversible encephalopathy syndrome [ 5 ]. Nevertheless, these causes should not be considered in the present case given the normal CSF pressure and unremarkable MRI findings beyond the optic nerves.…”

Section: Discussionmentioning

confidence: 99%

“…A recent Guillain-Barré syndrome (GBS) classification system proposed that PNC with both ocular and bulbar weakness in the absence of limb paralysis or ataxia in addition to the characteristics of GBS is defined as a rare variant of GBS [ 2 , 3 ]. As evidence of central nervous system (CNS) involvement, visual impairment is an unusual finding complicating with GBS spectrum disorders [ 4 – 6 ] and has never been reported in patients with PNC. Herein, we report a rare case with a clinical presentation of PNC and visual impairment possibly attributed to optic neuritis (ON) concurrently.…”

Section: Introductionmentioning

confidence: 99%

Co-occurrence of polyneuritis crainials and visual impairment: a case report and literature review

Huang

et al. 2022

Neurol Sci

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Background Polyneuritis cranialis (PNC) with the disease characteristics of Guillain-Barré syndrome (GBS) in addition to both ocular and bulbar weakness in the absence of limb paralysis or ataxia is defined as an unusual variant of GBS. As evidence of central nervous system (CNS) involvement, visual impairment is an unusual finding complicating with GBS spectrum disorders and has never been reported in patients with PNC. Methods We describe a very rare case who clinically presented with progressive multiple cranial nerve palsy and visual impairment. Furthermore, a literature search of concurrent GBS and optic neuritis (ON) as well as PNC attributed to GBS was conducted. Results A diagnosis of PNC was considered due to the typical clinical characteristics as well as the presence of cerebrospinal fluid cytoalbumin dissociation and serum antibodies against gangliosides. The clinical manifestations and the bilateral optic nerve involvement in brain magnetic resonance imaging further suggested possible optic neuritis (ON). The patient received treatment with intravenous immunoglobulin followed by short-term use of corticosteroids and finally achieved a full recovery. Thirty-two previously reported cases (17 women, mean age 40) of concurrent GBS and ON and 20 cases of PNC (5 women, mean age 40) were analyzed. We further provided a comprehensive discussion on the potential etiologies, clinical features, therapeutic strategies, and prognosis. Conclusions This rare case with the co-occurrence of PNC and visual impairment and the related literature review may help clinicians advance the understanding of GBS spectrum disorders and make appropriate diagnoses and treatment decisions for the rare variants and CNS complications of GBS. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-022-06580-0.

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“…En cuanto a los casos con hipertensión intracraneal, la causa de esta podría estar en la hiperproteinorraquia frecuentemente presente en el HaNDL. Al igual que ocurre en otras enfermedades como el síndrome de Guillain-Barré y el síndrome de polineuropatía, organomegalia, endocrinopatía, proteína monoclonal y cambios cutáneos (POEMS), la concentración aumentada de proteínas en el LCR podría disminuir la capacidad de absorción de las vellosidades aracnoideas causando hipertensión intracraneal 12,13 .…”

Section: Etiopatogeniaunclassified

Síndrome HaNDL

Terán¹,

Membrilla²

2024

KRANION

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El síndrome de cefalea y déficits neurológicos transitorios con linfocitosis de líquido cefalorraquídeo (HaNDL) es un cuadro infrecuente que cursa con focalidad neurológica y cefalea de características similares a la migraña en pacientes jóvenes. Tradicionalmente se ha considerado una enfermedad monofásica y de curso benigno, aunque no siempre es así. El manejo del síndrome HaNDL presenta dos retos principales: su correcta identificación precoz (p. ej., en casos con cefalea menos notable o con síntomas atípicos como la agitación psicomotriz) y el reconocimiento y manejo de la hipertensión intracraneal, que puede estar presente. En este trabajo se revisa el conocimiento científico actual sobre este síndrome, con especial interés en sus aspectos menos reconocidos.

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Case Report: Intracranial Hypertension Secondary to Guillain-Barre Syndrome

Cited by 10 publications

References 59 publications

Severe papilloedema with vision loss secondary to Guillain-Barré syndrome

Severe papilloedema with vision loss secondary to Guillain-Barré syndrome

Co-occurrence of polyneuritis crainials and visual impairment: a case report and literature review

Síndrome HaNDL

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