An Oculopharyngeal Subtype of Guillain-Barr é Syndrome Sparing the Trochlear and Abducens Nerves.
An Oculopharyngeal Subtype of Guillain-Barré Syndrome Sparing the Trochlear and Abducens Nerves. Intern Med. 2020 Feb 05;: Authors: Arakawa M, Yamazaki M, Toda Y, Ozawa A, Kimura K Abstract Guillain-Barré syndrome (GBS) comprises a group of polyneuropathies characterized by rapid progression of limb paralysis. Various subtypes of GBS have been reported. The oculopharyngeal subtype of GBS is currently understood to be primarily a cranial polyneuropathy without limb weakness or cerebellar ataxia. In our case of 62-year-old man, gastrointestinal infection was followed by paranesthesia of the hands. He had bilateral ptosis, pharyngeal disorder, and tongue and bifacial weakness. We diagnosed oculopharyngeal subtype of GBS. It responded to intravenous immunoglobulin. This case highlights the need for further characterization of unusual GBS subtypes. PMID: 32023583 [PubMed - as supplied by publisher]
We describe the case of a 7-year-old boy who presented with diplopia, speech difficulty, dysphagia, gait disturbance, and difficulty in eyeball movements since 5 days. On examination, the child was having ataxia, areflexia, ophthalmoplegia, drooling of saliva, dysphonia, and absent gag reflex. MFS and brain stem encephalitis were kept as the differential diagnoses. The patient improved gradually over 3 weeks, following a treatment with intravenous immunoglobulin.
Conclusion: PT intervention demonstrated improvement in functional outcomes for a patient with a diagnosis of MFS-GBS. Complex patients lacking recovery within 6 months may benefit from continued rehabilitation. Other intervention approaches may need to be considered, including aquatic therapy. PMID: 32149554 [PubMed - as supplied by publisher]
ConclusionsGiven the reversibility of clinical manifestations, Hashimoto ’s encephalopathy should be in the differential diagnosis of patients with unexplained seizures or encephalopathy who present with these symptoms or other involuntary movements.
Abstract The post-malaria neurological syndrome (PMNS) is an unusual and relatively underreported complication of malaria, which usually occurs after the resolution of acute febrile illness and the patient is free from parasitemia. The clinical spectrum of the PMNS varies from acute-onset cerebellar ataxia to significant encephalopathy with focal deficits resembling acute disseminated encephalomyelitis. Uncommon presentations of PMNS include Guillain-Barre syndrome, postural tremor, or even isolated neuropsychiatric features. Although in a significant proportion of PMNS cases clinical resolution occurs with conser...
In this report, a case of MFS is highlighted that was mistakenly treated as posterior circulation stroke, as well as the challenges faced in reaching the correct diagnosis and hence the appropriate treatment. PMID: 31808458 [PubMed - in process]
ConclusionsEven though Guillain-Barr é syndrome was recognized a century ago, there are still many unanswered questions about it and its florid presentation. Large-scale studies are needed for better understanding of its pathophysiology and prototypes and to find answers for still-unanswered questions. The clinician must have a high i ndex of suspicion and be familiar with mimics and prototypes to diagnose Guillain-Barré syndrome accurately without delay.
ConclusionThe PCB and MFS variant are rare forms of GBS. Ataxia commonly described in both of our cases may lead to overlapping syndrome and supports the view that PCB and MFS belongs to a continuous spectrum. Ataxia makes also difficult to differentiate these clinical entities from brainstem injury. However, areflexia and ENMG help to make the diagnosis. Further studies are needed to clarify whether these entities have specific patterns in electrophysiological studies.
In this study, we assessed the suitability of TSPO as an imaging biomarker of neuroinflammation in the context of acute and protracted ZIKV-induced neurological disease in a murine model. Methods: All animal studies were approved by the Institutional Animal Care and Use Committee (IACUC) of Duke-NUS Medical School. AG129 mice (deficient in interferon (IFN) α/β and receptors) were infected with lethal doses of ZIKV Paraiba01/Brazil or Uganda MR766 strain. Neurological examinations and general health examinations were conducted daily post-infection. Moribund mice were sacrificed, and the brains were harvested. Bra...
We examined the clinical and serologic features of Guillain-Barré syndrome (GBS)-related diseases (GBSRDs), including GBS, Fisher syndrome (FS), and Bickerstaff brainstem encephalitis (BBE), after influenza virus infection (GBSRD-I) to reveal potential underlying autoimmune mechanisms. Methods We retrospectively investigated the presence of antiglycolipid antibodies against 11 glycolipids and the clinical features of 63 patients with GBSRD-I. Autoantibody profiles and clinical features were compared with those of 82 patients with GBSRDs after Campylobacter jejuni infection (GBSRD-C). Results The anti-GQ1b seroposi...