Guillain-Barré syndrome in pregnancy: A conservatively managed case

Fernando, T N M S; Ambanwala, A M A S; Ranaweera, Probhodana; Kaluarachchi, Athula

doi:10.4103/2249-4863.197303

Cited by 11 publications

(8 citation statements)

References 14 publications

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“…A study conducted by Fernando et al . 13 showed the worsening condition of GBS in the postpartum period due to increase in delayed type of hypersensitivity. A similar study was conducted, which showed a case of GBS diagnosed at 15 weeks of pregnancy and aggravated in the postpartum period.…”

Section: Clinical Discussionmentioning

confidence: 99%

Postpartum Guillain–Barré syndrome: a case report

Bhusal

Shrestha

Muskan

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and Importance: Guillain–Barré syndrome (GBS) is an immune-mediated disorder of the central nervous system presenting as symmetrical, progressive weakness and areflexia. The incidence of GBS is very low during pregnancy, but the risk increases in the postpartum period. The management is done by intravenous immunoglobulin or conservatively. Case Presentation: Case of 27 years female with parity 1, living 1, on postpartum day 20 presented to the emergency department (ED) with weakness over legs and hands since 20 days following emergency lower segment cesarean section for her delivery. The weakness prevailed over the lower extremities and progressed to the upper extremities in 4–5 days, affecting her grip strength and ability to stand alone. No history of prior diarrheal or respiratory illness. Cerebrospinal fluid analysis revealed albuminocytologic dissociation. A nerve conduction study showed in-excitable bilateral radial, median, ulnar, and sural nerves. Intravenous immunoglobulin was administered at the rate of 0.4 g/kg once daily for 5 days. Patient was discharged after 2 weeks with regular physiotherapy follow-up. Conclusion: GBS in the postpartum period is very rare. There must be a high degree of suspicion among physicians for GBS if a pregnant female or a woman during her postpartum period presents with ascending muscle paralysis, even if there is no recent antecedent history of diarrheal episodes or respiratory illness. An early diagnosis with multidisciplinary supportive measures helps improve the prognosis for both the mother and the fetus.

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Section: Clinical Discussionmentioning

confidence: 99%

Postpartum Guillain–Barré syndrome: a case report

Bhusal

Shrestha

Muskan

et al. 2023

Annals of Medicine &Amp; Surgery

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“…Estimated population incidence ranges from 0.62 to 2.66 cases per 100,000 person-years across all age groups. 6 Its occurrence can be established as 13% in the first trimester, 47% in the second trimester, and 40% in the third trimester. 7 It is usually preceded by a bacterial or viral infection.…”

Section: Discussionmentioning

confidence: 99%

Guillain-Barre syndrome in pregnancy- a rare entity

Pakhale¹,

Sehra²,

S.L.Bhardwaj³

2020

Int J Reprod Contracept Obstet Gynecol

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Guillain-Barre syndrome (GBS) is a rare, autoimmune disorder. Estimated incidence is 0.62 to 2.66 cases per 100000 people annually. We report a case of GBS in 29 years old primigravida with pre-gestational diabetes mellitus controlled on insulin, who presented at 7 weeks of the period of gestation with complaints of numbness in both hands and fingers. After 3 days of hospital admission, she had progressive weakness in both limbs and difficulty in walking. MRI of the brain and spinal cord done to exclude other possible causes and was normal. All the other blood investigations including electrolytes were normal. Nerve conduction velocity test was suggestive of acute inflammatory demyelinating axonal motor polyneuropathy and diagnosis of GBS was made. She was managed by multidisciplinary approach in intensive care unit. The patient improved after plasmapheresis and supportive measures as thromboembolism prophylaxis and physiotherapy. Patient was discharged after 2 weeks of hospital stay and had no residual symptoms after 1 month. She was readmitted at 32 weeks of gestation with severe preeclampsia and underwent emergency cesarean section delivering 1.9 kg male baby. She was discharged on day 4 of cesarean section and followed in postpartum period for complications. To summarize, GBS can appear at any stage of pregnancy & postpartum. Diagnosis can be delayed, so needs high index of clinical suspicion. Early diagnosis along with prompt intensive multidisciplinary supportive care improves outcomes for the mother and foetus.

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“…Intravenous immunoglobulin (IVIG) therapy and plasma exchange hasten early recovery, but even in cases when these treatments are used approximately 20% of the patients are left with severe disability, such as requiring support to walk (12).…”

Section: Introductionmentioning

confidence: 99%

Physiotherapy for complete motor recovery in 4-year-old child with Guillain Barre syndrome- A case study

Rajalaxmi¹,

Dhanusia²,

Kumar³

et al. 2022

Biomedicine

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This study was conducted in 4-year-old male child in sub-acute stage of Guillain Barre Syndrome (GBS) for 12 weeks in a local clinical setup after discharge from the hospital completing IVIG dose. Physiotherapy was given for 12 weeks, 5 days in a week of 1 and half hour session per day with rest periods between the session. Physiotherapy intervention includes passive – active exercise, resisted exercise, weight bearing exercise, mat activities, breathing exercises, task-oriented exercise, balance and coordination exercise, abdominal strengthening, gait training, and play activities. Outcomes used before and after the intervention were Manual Muscle Test (MMT), Five Times Sit to Stand Test (FTSST), Functional independent Measure (FIM), Time Up and Go test (TUG) and Hand dynamometer to analyse the effects of physiotherapy intervention. This study concluded that there was a significant improvement in patient’s motor functions and independence in daily activities after an effective physiotherapy treatment. There was a complete motor recovery after 12 weeks of physiotherapy.

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Guillain-Barré syndrome in pregnancy: A conservatively managed case

Cited by 11 publications

References 14 publications

Postpartum Guillain–Barré syndrome: a case report

Postpartum Guillain–Barré syndrome: a case report

Guillain-Barre syndrome in pregnancy- a rare entity

Physiotherapy for complete motor recovery in 4-year-old child with Guillain Barre syndrome- A case study

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