Causes and consequences of diagnostic delay in <scp>Guillain‐Barré</scp> syndrome in a UK tertiary center

Bose, Shiti; Loo, Lay Khoon; Rajabally, Yusuf A.

doi:10.1002/mus.27506

Cited by 9 publications

(4 citation statements)

References 7 publications

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“…Interestingly, we observed the delay between GBS onset and hospital admission was longer in pGBS in comparison with npGBS, i.e., 9 days vs 6 days, and we wondered whether this increased delay might play a role in our findings. However, a recent retrospective study showed there was no correlation between GBS diagnostic delay and ICU admission, mechanical ventilation, and inpatient mortality [ 11 ]. We also wondered whether pregnancy-related physiological changes might explain the difference between pGBS and npGBS.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and maternal and fetal outcomes in women with Guillain-Barré syndrome in pregnancy

et al. 2023

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Background Guillain–Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy. Methods In this retrospective study, we analyzed the characteristics of pregnant women with GBS (pGBS) diagnosed in French University Hospitals in the 2002–2022 period and compared them with a reference group of same-age non-pregnant women with GBS (npGBS) identified in the same institutions & timeframe. Results We identified 16 pGBS cases. Median age was 31 years (28–36), and GBS developed in the 1st, 2nd, and 3rd trimester in 31%, 31% and 38% of cases respectively. A previous infection was identified in six cases (37%), GBS was demyelinating in nine cases (56%), and four patients (25%) needed respiratory assistance. Fifteen patients (94%) were treated with intravenous immunoglobulins, and neurological recovery was complete in all cases (100%). Unscheduled caesarean section was needed in five cases (31%), and two fetuses (12.5%) died because of cytomegalovirus (CMV) infection (1 case) and HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome (1 case). In comparison with a reference group of 18 npGBS women with a median age of 30 years (27–33), pGBS patients more frequently had CMV infection (31% vs 11%), had a prolonged delay between GBS onset and hospital admission (delay > 7 days: 57% vs 12%), more often needed ICU admission (56% vs 33%) and respiratory assistance (25% vs 11%), and more often presented with treatment-related fluctuations (37% vs 0%). Conclusions This study shows GBS during pregnancy is a severe maternal condition with significant fetal mortality. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-023-11808-w.

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Section: Discussionmentioning

confidence: 99%

Clinical features and maternal and fetal outcomes in women with Guillain-Barré syndrome in pregnancy

et al. 2023

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“…Prompt treatment in combination with adequate physical therapy thus proved to be an appropriate treatment course for this patient. In considering atypical variants of GBS, prompt treatment is of even greater importance since ambiguity surrounding the correct diagnosis may delay treatment and therefore permit further disease progression [ 12 ]. Hence, this case also demonstrates the importance of early recognition of both classic and atypical clinical patterns in order to appropriately diagnose and treat patients in a timely manner so as to prevent complications.…”

Section: Discussionmentioning

confidence: 99%

Atypical Guillain-Barré Syndrome Presenting After COVID-19 Infection

Noon¹,

Malhi²,

Wong³

2022

Cureus

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Guillain-Barré syndrome (GBS) is an acute autoimmune disease affecting the peripheral nervous system presenting as a symmetric, ascending polyneuropathy. The syndrome arises after a stimulus, such as infection or vaccination, and provokes an autoimmune response in the body. Common symptoms include rapidly progressive weakness in the extremities and generalized hyporeflexia or areflexia. However, GBS may have various presentations, which can make for a challenging diagnosis. We present a case of a 46-year-old female with asymmetric ascending weakness, paresthesias, and acute onset urinary retention occurring after Coronavirus Disease 2019 (COVID-19) infection. Of note, this patient did not present with albuminocytologic dissociation in cerebrospinal fluid (CSF) studies. The complex presentation of her symptoms prompted a diagnosis of atypical GBS. Her diagnosis was achieved through a series of diagnostic tests ruling out other etiologies, such as meningitis and spinal cord compression syndromes.

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“…For example, in the case of rare variants such as the pharyngeal-cervical-brachial (PCB) variant or acute bulbar palsy (ABP)-plus syndrome, prominent bulbar palsy may be the first or sole clinical manifestation [ 5 , 6 ]. Patient-specific factors, such as age >60 years, pre-existing medical diseases, and atypical clinical presentations, have been recognized as factors significantly associated with both delayed diagnosis and increased mortality in cases of GBS [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Isolated Acute Dysphagia as a Probable Rare Presentation of Guillain–Barré Syndrome with Complete Recovery: A Case Report

Lee,

Jung,

Yoon

et al. 2024

Geriatrics

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Dysphagia is prevalent among the elderly and can lead to serious complications, often manifesting as a clinical symptom of various neurological or muscular pathologies, including Guillain–Barré Syndrome (GBS). GBS is an acute immune-mediated polyradiculoneuropathy, and dysphagia may arise during its course due to cranial nerve involvement. In rare GBS variants, dysphagia may present as the initial or sole clinical manifestation, posing diagnostic challenges. In this study, we present the case of an elderly female patient with dysphagia, eventually diagnosed with an atypical variant of GBS. Initially, the patient required nasogastric tube feeding; however, complete recovery was achieved through immunotherapy. This case underscores the importance of clinicians conducting thorough evaluations of factors influencing the swallowing mechanism and remaining vigilant about identifying uncommon causative factors. Such approaches enable the implementation of effective disease-modifying therapies, potentially leading to the resolution of dysphagic symptoms.

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Causes and consequences of diagnostic delay in Guillain‐Barré syndrome in a UK tertiary center

Cited by 9 publications

References 7 publications

Clinical features and maternal and fetal outcomes in women with Guillain-Barré syndrome in pregnancy

Clinical features and maternal and fetal outcomes in women with Guillain-Barré syndrome in pregnancy

Atypical Guillain-Barré Syndrome Presenting After COVID-19 Infection

Isolated Acute Dysphagia as a Probable Rare Presentation of Guillain–Barré Syndrome with Complete Recovery: A Case Report

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