Study of Cerebrospinal Fluid (CSF) and Clinical and Electrophysiological Features of Hospitalized Patients with Gullain-Barre´ Syndrome.

Background: Since the elimination of poliomyelitis from most part of the world Gullain-Barre' Syndrome (GBS) has been the leading cause of acute flaccid paralysis which leads to substantial morbidity and mortality. Though GBS has received a lot of attention in developed countries, there is a paucity of reports on the GBS from the developing world including Bangladesh. Objective: The objective of the study was to correlate clinical, cerebrospinal fluid (CSF) and electrophysiological findings of hospitalized Gullain-Barre´ syndrome patients for early diagnosis and appropriate management. Materials and Methods: A total of 47 clinically diagnosed GBS patients admitted in Neurology, Medicine and Pediatrics departments of Dhaka Medical College Hospital (DMCH) were included in this quasi-experimental study. Biochemical, cytological and bacteriological studies of CSF of these patients were done. Electrophysiological studies of all subjects were done and values were compared with upper and lower limits of normal. Results: In this study, antecedent event were present in 55.30% cases and upper respiratory infection (23.40%) and gastroenteritis (21.30%) were the commonest antecedent disorders. All the study patients had numbness or paresthesia and limb weakness, and muscle pain was in 44.7% cases, facial weakness in 36.2% cases, ophthalmoplegia or ptosis in 6.4% and bulbar involvement was in 6.4% cases. Most of the patients (95.7%) had deep tendon hypo/areflexia followed by respiratory distress (21.3%), and ataxia (19.1%). Majority of the study patients (57.4%) required one week time to develop maximum deficit. Maximum subjects (70.2%) had motor type GBS followed by sensorimotor type (21.3%), Miller-Fisher type (6.4%) and sensory type (2.1%). Eighty three percent of the study patients had CSF protein concentration >45 mg/dL with mean ± SD of 71.32 ± 20.20 mg/dL (37–112 mg/dL). The cell count in CSF was <5 per mm3 in 95.7% of the study patients with mean ±SD cell count of 3.2 ± 1.80/mm3 (2–15 cells per mm3). The mean ± SD time to perform EMG was 9.4 ± 3.6 days with a range from 5–17 days and the mean ± SD disability grade at that time to EMG was 3.6 ± 0.9 with a range from 2–5. Regarding the electrodiagnostic types, the commonest pattern (40.40%) was found AIDP, AMAN was 29.80%, AMSAN 19.15% and mixed pattern was in 10.65% of the patients. Conclusion: This study reveals that clinical, CSF and electrophysiological findings accurately diagnose the GBS patients along with typing of GBS.

Post dengue neurological complication

Dengue infection is highly endemic in many tropical countries including Malaysia. However, neurological complications arising from dengue infection is not common; Gullain–Barre syndrome (GBS) is one of these infrequent complications. In this paper, we have reported a case in which a 39-year-old woman presented with a neurological complication of dengue infection without typical symptoms and signs of dengue fever. She had a history of acute gastroenteritis (AGE) followed by an upper respiratory tract infection (URTI) weeks prior to her presentation rendering GBS secondary to the post viral URTI and AGE as the most likely diagnosis. Presence of thrombocytopenia was the only clue for dengue in this case.

Elevated in Anti-GQ1b and Anti-GT1a IgG Antibody Titers in an Overlap Case of Pharyngeal-Cervical-Brachial Variant of Guillain-Barre Syndrome and Miller-Fisher Syndrome / 대한임상신경생리학회지

No abstract available.

Anesthetic Management of Cesarean Section in Parturient with Guillain-Barre Syndrome: A case report / 대한마취과학회지

Guillain-Barre syndrome (GBS) is an acute demyelinating polyneuropathy, associated with symmetrical muscle weakness, areflexia, and ascending paralysis. Although it has been reported during all the three trimesters of pregnancy and in the post-partum period, the occurrence of GBS in the third trimester presents a high maternal risk because of respiratory complications and the risk of premature delivery. We report the successful anesthetic management of a parturient with GBS.

The influence on costimulatory molecules expression by electroacupuncture at Shu-points of the Five Zang-organ for the acute allergy neuritis in domestic rabbit's / 中国免疫学杂志

Objective:To observe the influence of electroacupuncture at Shu-points of the Five Zang-organ in domestic rabbits with acute allergy neuritis,a classical animal model,and to explore the immunoregulatory mechanism responsible for the regimen by detecting expression of the costimulatory molecules in sciatic nerve.Methods:ELISA was used to examine proteins of CD28,CTLA-4,B7-1,B7-2 in sciatic nerve of P2 immunized EAN domestic rabbits.Results:It was showed that the expression of CTLA-4 and B7-2 was obviously up-regulated(P