Significance of Brighton Criteria in the Early Diagnosis and Management of Guillain-Barré Syndrome

Ghazanfar, Haider; Qazi, Rabia; Ghazanfar, Ali; Iftekhar, Sania

doi:10.7759/cureus.8318

Cited by 22 publications

(22 citation statements)

References 5 publications

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“…Last, the Brighton Criteria can serve as an additional tool to assist in diagnosing GBS and help distinguish between low- and high-risk patients. The Brighton Criteria is based on the diagnostic criteria, including extremity weakness, CSF values, NSC findings, the course of the disease, and the absence of an alternative diagnosis [ 25 ]. As a result, it cannot be calculated without results from NCS/EMG for our particular MFS case.…”

Section: Discussionmentioning

confidence: 99%

Miller-Fisher Syndrome Presenting as Facial Diplegia With COVID-19 Co-Infection

Tran¹,

Drury²,

Yuen³

et al. 2021

Cureus

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Coronavirus disease 2019 (COVID-19) has reportedly been associated with various neurological manifestations, including unilateral facial palsy and, very rarely, facial diplegia. We present a unique case of Miller-Fisher Syndrome (MFS), a variant of Guillain-Barré Syndrome (GBS) that was noted in conjunction with a COVID-19 infection. In this case, a patient presented with bilateral facial palsy, dysarthria, right-sided hemiparesis, ataxia, and the confirmation of SARS-CoV-2 infection. His computed tomography (CT) scan of the brain and serology test results did not support alternate etiologies for facial palsy. His cerebrospinal fluid (CSF) studies demonstrated albuminocytologic dissociation, which was consistent with the diagnosis of MFS and further supported by his ataxia and ophthalmoplegia. A five-day course of intravenous immunoglobulin (IVIG) therapy combined with physical, occupational, and speech therapy improved his recovery.

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Section: Discussionmentioning

confidence: 99%

Miller-Fisher Syndrome Presenting as Facial Diplegia With COVID-19 Co-Infection

Tran¹,

Drury²,

Yuen³

et al. 2021

Cureus

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“…The diagnosis of GBS with the Brighton Criteria requires clinical symptoms of progressive limb weakness, decreased deep tendon reflexes or areflexia, and abnormal laboratory and abnormal conduction study findings. 9 Case reports of COVID-19-associated GBS have described the onset of weakness from 5 days to 21 days after the start of COVID-19 symptoms. 5 , 6 Guillain–Barre syndrome (GBS) symptom progression is often rapid and last from days to 4 weeks, with relative symmetry.…”

Section: Discussionmentioning

confidence: 99%

Guillain–Barre Syndrome Associated With COVID-19 Pneumonia—The First Documented Case in a U.S. Military Intensive Care Unit

et al. 2021

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Coronavirus disease 2019 (COVID-19) is a significant cause for intensive care unit (ICU) admission worldwide. Most COVID-19 infections are associated with lower respiratory abnormalities but it has been increasingly associated with extra-pulmonary manifestations. Guillain–Barre syndrome (GBS) is a rarely diagnosed but severe disease associated with COVID-19 infection. We describe the diagnostic process behind diagnosing GBS in an elderly male who developed acute-onset quadriparesis and respiratory muscle failure associated with severe COVID-19 pneumonia in a military ICU. A 69-year-old male was admitted to the ICU for acute hypoxemic respiratory failure due to COVID-19 pneumonia. He was subsequently intubated and treated with dexamethasone and remdesivir with improvement. On hospital day 32, the patient was extubated. Three days later, he developed acute, symmetric limb quadriparesis and respiratory muscle failure requiring reintubation. Analysis of his cerebrospinal fluid showed a cytoalbuminologic dissociation, and electromyography/nerve conduction study showed slowed nerve conduction velocity. These findings are consistent with GBS. Blood cultures, serum polymerase chain reaction testing, and clinical symptoms were not suggestive of other common pathogens causing his GBS. The patient’s acute GBS in the setting of recent severe COVID-19 infection strongly suggests association between the two entities, as supported by a growing body of case literature. The patient was subjected to intravenous immunoglobulin treatment and was discharged with greatly improved strength in the upper and lower extremities. Our goal in describing this case is to highlight the need for providers to consider, accurately diagnose, and treat GBS as a consequence of severe COVID-19 infection.

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“…The patients who were discharged with no complications were categorized as 'favorable' (complete recovery), those who recovered but needed assistance and further rehabilitation were listed as 'partial recovery', and patients who remained bedridden and intubated were classi ed as 'poor' outcome. Moreover, The level of diagnostic certainty was evaluated via Brighton criteria for each case [25]. Due to the qualitative and summative nature of this review and signi cant variations in study designs and reporting of ndings, a meta-analysis and statistical calculations were not performed.…”

Section: Methodsmentioning

confidence: 99%

Guillain-Barré Syndrome in Association with COVID-19 Vaccination: A Systematic Review

Abolmaali

Rezania

Behnagh

et al. 2022

Preprint

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Since the beginning of worldwide vaccination against coronavirus disease 2019 (COVID-19), studies have reported a possible association between vaccination and Guillain-Barré syndrome (GBS). In this regard, we conducted a systematic review assessing different demographic, clinical, and neurophysiological aspects of patients with GBS following immunization with COVID-19 vaccines. A comprehensive search of PubMed, Web of Science, Scopus, and Google Scholar was performed. Articles in English between January 2020 and November 2021 were included. Data on demographics, clinical characteristics, vaccines information, treatment approaches, and outcomes were extracted. The data of a total of 88 patients out of 41 studies was included. The mean age of patients was 58.7 ± 16.6 years and 55 cases (62.5%) were male. AstraZeneca was the most-reported vaccine associated with GBS with 52 cases (59.1%) followed by Pfizer with 20 cases (22.7%). GBS occurred after the first dose of vaccination in 70 cases (79.5%). The mean time interval between vaccination and symptom onset was 13.9 ± 7.4 days. Limb weakness (47.7%), sensory disturbance (38.6%), and facial weakness (27.3%) were the most common reported symptoms, respectively. Albuminocytologic dissociation was seen in 65% of patients who underwent lumbar puncture (n = 65). Acute inflammatory demyelinating polyradiculopathy was the most common GBS subtype, which was reported in 38 patients (43.2%). While one-fifth of patients underwent intubation (n = 17), a favorable outcome was achieved in the majority of subjects (n = 46, 63%). Overall, a small rise in GBS incidence, following various COVID-19 vaccines, was observed. Notably, 85% of affected individuals experienced at least a partial recovery.

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Significance of Brighton Criteria in the Early Diagnosis and Management of Guillain-Barré Syndrome

Cited by 22 publications

References 5 publications

Miller-Fisher Syndrome Presenting as Facial Diplegia With COVID-19 Co-Infection

Miller-Fisher Syndrome Presenting as Facial Diplegia With COVID-19 Co-Infection

Guillain–Barre Syndrome Associated With COVID-19 Pneumonia—The First Documented Case in a U.S. Military Intensive Care Unit

Guillain-Barré Syndrome in Association with COVID-19 Vaccination: A Systematic Review

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