Post COVID-19 Guillain-Barre syndrome presents as sensory dominant neuropathy with reversible conduction failure.

Guillain-Barré syndrome (GBS) has several clinical variants. The sensory presentations of GBS are atypical but well-recognized. We report a patient who presented with predominantly sensory symptoms associated with reversible conduction failure (RCF). RCF is a well-defined neurophysiological abnormality noted mainly in axonal GBS and may be misinterpreted as evidence of demyelination. A 25-year-old woman presented 2 weeks after a coronavirus 2019 infection with acute sensory symptoms, distal allodynia, mild weakness, and mild hyporeflexia in her upper limbs. A nerve conduction study (NCS) showed delayed motor distal latencies, and lumbar puncture confirmed cytoalbuminologic dissociation. After excluding other etiologies, she was diagnosed with GBS, treated with an IV immunoglobulin course, and showed remarkable recovery. Results of a repeat NCS were consistent with RCF and confirmed the presence of axonal GBS. Increased awareness of sensory GBS and RCF is expected to improve the diagnosis and management of atypical GBS presentations.

The Impact of the COVID-19 Pandemic on Ophthalmic Outpatient Care in a Tertiary Care Center in Riyadh.

In this paper, we measured the impact of a full COVID-19 lockdown on ophthalmic patients after a period of lockdown in Saudi Arabia, from March to September 2020. A cross-sectional analytical study was carried out on 180 patients who had their appointments delayed or canceled due to the lockdown. Data was collected from electronic medical records and patients via voice calls using a validated questionnaire that were analyzed using a multivariable binary regression analysis. The results show no statistically significant mean difference in visual acuity when comparing pre- and post-lockdown measurements. The median number of appointment cancellations/delays per patient was two, and the estimated delay for the first canceled appointments was equal to 178.8 days. Of the cohort studied, 15.4% of patients faced delays in necessary surgical and therapeutic interventions; 22.1% of patients sought eye care at other institutions due to the delay, and 15% of those were seen by doctors unspecialized in ophthalmology. The odds of dissatisfaction with care were higher in patients who experienced cancellations in a surgical procedure and patients who experienced difficulty in obtaining medications. In conclusion, the pandemic hampered ophthalmic patients' access to medications. Subjective visual outcomes of patients were also negatively affected; however, the change in objective visual parameters was not statistically significant.