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Guillain-Barré syndrome as only manifestation of COVID-19 infection.
d'Orsi, Giuseppe; Sica, Salvatore; Maiorano, Annamaria; Melchionda, Donato; Lalla, Alessandra; Montemurro, Laura; Sabetta, Annarita; Goffredo, Rossana; Lecce, Brunello; Fiore, Jose Ramon; Santantonio, Teresa; Avolio, Carlo.
  • d'Orsi G; S.C. Neurologia Universitaria, Policlinico Riuniti, Foggia, Italy. Electronic address: giudorsi@yahoo.it.
  • Sica S; S.C. Malattie Infettive Universitaria, Policlinico Riuniti, Foggia, Italy.
  • Maiorano A; S.C. Nefrologia Universitaria, Policlinico Riuniti, Foggia, Italy.
  • Melchionda D; S.C. Neurologia Universitaria, Policlinico Riuniti, Foggia, Italy.
  • Lalla A; S.C. Neurologia Universitaria, Policlinico Riuniti, Foggia, Italy.
  • Montemurro L; S.C. Malattie Infettive Universitaria, Policlinico Riuniti, Foggia, Italy.
  • Sabetta A; S.C. Neurologia Universitaria, Policlinico Riuniti, Foggia, Italy.
  • Goffredo R; S.C. Neurologia Universitaria, Policlinico Riuniti, Foggia, Italy.
  • Lecce B; S.S. Neurofisiologia Clinica, Policlinico Riuniti, Foggia, Italy.
  • Fiore JR; S.C. Malattie Infettive Universitaria, Policlinico Riuniti, Foggia, Italy.
  • Santantonio T; S.C. Malattie Infettive Universitaria, Policlinico Riuniti, Foggia, Italy.
  • Avolio C; S.C. Neurologia Universitaria, Policlinico Riuniti, Foggia, Italy.
Clin Neurol Neurosurg ; 207: 106775, 2021 08.
Article in English | MEDLINE | ID: covidwho-1338371
ABSTRACT
Post-infectious/immune mediated effects of COVID-19 infection include descriptions of Guillain-Barré syndrome (GBS) in patients usually with respiratory failure and after 1-2 weeks from the onset of viral illness. Asymptomatic cases for COVID-19 infection were rarely described. Herein, we studied a 62-year-old patient with progressive weakness of lower extremities, rapidly evolving to a severe, flaccid tetraplegia and dysphagia. Neurological symptoms weren't preceded by fever or pulmonary symptoms. Because of laboratory test abnormalities (thrombocytopenia, lymphocytopenia, high inflammation indexes), the patient underwent to nasopharyngeal swab, resulted positive for SARS-CoV-2 on RT-PCR assay; cerebrospinal fluid (CSF) was negative for SARS-CoV-2. The clinical (severe symmetric distal upper and lower limbs weakness, grade 0/5; decreased proprioceptive sensitivity and hypoesthesia involving the four limbs; loss of deep tendon reflexes), electrophysiological (prevailing axonal polyradiculoneuritis) and CSF features (albumino-cytological dissociation) disclosed the GBS diagnosis (level 1 of diagnostic certainty according to the Brighton criteria). The patient received plasma exchange and immunoglobulin, and, at 4 weeks after treatment and physical therapy, the patient had moderate improvement (weakness at lower and upper extremities was grade 2/5 and 3/5, respectively). Neurologists and clinicians should be aware of the possible link between neurological symptoms and COVID-19 infection, not only after viral prodrome and pulmonary symptoms, but also without COVID-19 symptoms.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Guillain-Barre Syndrome / COVID-19 Type of study: Case report Limits: Humans / Male / Middle aged Language: English Journal: Clin Neurol Neurosurg Year: 2021 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Guillain-Barre Syndrome / COVID-19 Type of study: Case report Limits: Humans / Male / Middle aged Language: English Journal: Clin Neurol Neurosurg Year: 2021 Document Type: Article