Corticosteroids for Guillain-Barré syndrome

Hughes, Richard; Brassington, Ruth; Gunn, Angela A; Doorn, Pieter A. van

doi:10.1002/14651858.cd001446.pub5

Cited by 107 publications

(83 citation statements)

References 32 publications

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“…It is not yet known whether IVIG given over 2 days or 5 days is more beneficial. The combination of IVIG and methylprednisolone is not significantly better than IVIG alone 10. Similarly, combination of plasmapheresis and IVIG is not more effective than either therapy alone 11.…”

Section: Discussionmentioning

confidence: 92%

Guillain-Barré syndrome in association with antitumour necrosis factor therapy: a case of mistaken identity

Patwala

Crump

Cruz³

2017

BMJ Case Reports

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Guillain-Barré syndrome (GBS) is an immune-mediated disease characterised by evolving ascending limb weakness, sensory loss and areflexia. Two-thirds of GBS cases are associated with preceding infection. However, GBS has also been described in association with antitumour necrosis factor (TNF) therapies including infliximab and adalimumab for chronic inflammatory disorders such as rheumatoid arthritis, ankylosing spondylitis and inflammatory bowel disease. We present the case of a patient who developed GBS while undergoing treatment with adalimumab in combination with azathioprine for severe fistulising Crohn's disease, and review the literature on neurological adverse events that occur in association with anti-TNF therapy. We also propose an approach to the optimal management of patients who develop debilitating neurological sequelae in the setting of anti-TNF therapy.

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Section: Discussionmentioning

confidence: 92%

Guillain-Barré syndrome in association with antitumour necrosis factor therapy: a case of mistaken identity

Patwala

Crump

Cruz³

2017

BMJ Case Reports

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“…The conclusion of the Cochrane systematic review on corticosteroids in 587 patients was that they do not significantly hasten recovery from GBS or affect the long term outcome. 43 A detailed description of the larger randomized controlled studies that led to this conclusion and other treatment recommendations in inflammatory demyelinating polyneuropathies are provided in Table 2. In contrast to corticosteroids, treatment of GBS patients with plasma exchange has been shown to increase the rate of recovery and the likelihood of full recovery (five trials with 404 participants, RR 1.24 (95% CI 1.07 to 1.45)) and decrease the likelihood of residual severe weakness compared to supportive care.…”

Section: Disease Modifying Therapymentioning

confidence: 99%

The Importance of Rare Subtypes in Diagnosis and Treatment of Peripheral Neuropathy

et al. 2015

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Importance-Peripheral neuropathy is a prevalent condition that usually warrants a thorough history and examination, but limited diagnostic evaluation. Rare localizations of peripheral neuropathy, however, often require more extensive diagnostic testing and different treatments.Objective-To describe rare localizations of peripheral neuropathy, including the appropriate diagnostic evaluation and available treatments.Evidence Review-References were identified from PubMed searches with an emphasis on systematic reviews and randomized clinical trials. Articles were also identified through the use of the author's own files. Search terms included common rare neuropathy localizations and their causes, as well as epidemiology, pathophysiology, diagnosis, and treatment.Findings-Diffuse, non-length dependent neuropathies, multiple mononeuropathies, polyradiculopathies, plexopathies, and radiculoplexus neuropathies are rare peripheral neuropathy localizations that often require extensive diagnostic testing. Atypical neuropathy features, such as acute/subacute onset, asymmetry, and/or motor predominant signs, are frequently present. The most common diffuse, non-length dependent neuropathies are Guillain-Barre syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP), multifocal motor neuropathy (MMN), and amyotrophic lateral sclerosis (ALS). Effective disease modifying therapies exist for many diffuse, non-length dependent neuropathies including GBS, CIDP, MMN, and some paraprotein-associated demyelinating neuropathies. Vasculitic neuropathy (multiple mononeuropathy) also has efficacious treatment options, but definitive evidence of a treatment effect for IgM anti-MAG neuropathy and diabetic amyoptrophy (radiculoplexus neuropathy) is lacking.Conclusions and Relevance-Recognition of rare localizations of periperhal neuropathy is essential given the implications for diagnostic testing and treatment. Electrodiagnostic studies are

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“…A diagnosis of atypical variant of MFS with positive cerebrospinal fluid GQ1b antibody was made with notable optic neuropathy. The optic changes confirmed by fundoscopy and magnetic resonance imaging optic nerve enhancement validated the use of pulse steroids, despite some evidence suggesting that steroids provide no functional benefit in the recovery of patients with GBS and may actually delay clinical recovery . Our patient's clinical deterioration in visual acuity prompted reconsideration of steroid use to prevent further visual loss.…”

Section: Investigation Resultsmentioning

confidence: 99%

An unusual presentation of Miller Fisher syndrome with optic neuropathy

Lubomski

Tisch

2016

Internal Medicine Journal

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Corticosteroids for Guillain-Barré syndrome

Abstract: Publication status and date: New search for studies and content updated (no change to conclusions), published in Issue 10, 2016.

Cited by 107 publications

References 32 publications

Guillain-Barré syndrome in association with antitumour necrosis factor therapy: a case of mistaken identity

Guillain-Barré syndrome in association with antitumour necrosis factor therapy: a case of mistaken identity

The Importance of Rare Subtypes in Diagnosis and Treatment of Peripheral Neuropathy

An unusual presentation of Miller Fisher syndrome with optic neuropathy

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