Guillain-Barré Syndrome

This article reviews the clinical features, diagnosis and differential diagnosis, prognosis, pathogenesis, and current and upcoming treatments of Guillain-Barré syndrome (GBS). RECENT FINDINGS GBS is an acute inflammatory neuropathic illness with striking clinical manifestations and significant morbidity. A substantial proportion of patients with GBS do not respond to current immunomodulatory therapies (ie, plasma exchange and IV immunoglobulin [IVIg]), highlighting the need for new therapies. Prognostic models that can accurately predict functional recovery and the need for artificial ventilation have emerged. These models are practical, and online calculators are available for clinical use, facilitating early recognition of patients with poor outcome and the opportunity to personalize management decisions. Clinical and experimental studies have identified innate immune effectors (complement, macrophage lineage cells, and activating Fcγ receptors) as important mediators of inflammatory nerve injury. Two complement inhibitors are undergoing clinical testing for efficacy in GBS. SUMMARY GBS is the most common cause of acute flaccid paralysis in the United States and worldwide. New treatments for GBS have not emerged since the 1990s. Our understanding of the pathogenesis of this disorder has progressed, particularly over the past decade; as a result, new therapeutic agents targeting different components of the complement cascade are at advanced stages of clin...
Source: CONTINUUM: Lifelong Learning in Neurology - Category: Neurology Tags: REVIEW ARTICLES Source Type: research

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Publication date: Available online 8 October 2020Source: Neurología (English Edition)Author(s): O. Barrachina-Esteve, A. Palau Domínguez, I. Hidalgo Torrico, M.L. Viguera Martinez
Source: Neurologia - Category: Neurology Source Type: research
Publication date: Available online 8 October 2020Source: Neurología (English Edition)Author(s): LM Trujillo Gittermann, SN Valenzuela Feris, A von Oetinger Giacoman
Source: Neurologia - Category: Neurology Source Type: research
Publication date: Available online 8 October 2020Source: Neurophysiologie CliniqueAuthor(s): Céline Tard, Claude-Alain Maurage, Andre Maues de Paula, François Cassim, Arnaud Delval, Grégory Kuchcinski, Jean-Baptiste Davion, Luc Defebvre, Mohammed Bouchiba, Intensive Care Unit Medical Group, Mercedes Jourdain, Joseph Boucraut
Source: Neurophysiologie Clinique - Category: Neuroscience Source Type: research
da HR Abstract The Northeast of Brazil has experienced a triple epidemic, with the simultaneous circulation of dengue virus (DENV), chikungunya virus (CHIKV) and Zika virus (ZIKV), which may have contributed to the observed increase across this region of atypical forms of disease and deaths. In view of this fact, non-congenital neurological disorders related to arboviruses were compared with other etiologies, mortality and survival rates of patients admitted to referral neurology hospitals in Pernambuco State, Northeast Brazil, from 2015 to 2018. Blood and cerebrospinal fluid samples were collected and tested usin...
Source: Revista do Instituto de Medicina Tropical de Sao Paulo - Category: Tropical Medicine Authors: Tags: Rev Inst Med Trop Sao Paulo Source Type: research
Peripheral neuropathies including Guillain ‐Barré syndrome may be linked to life‐threatening COVID‐19. Plasma exchange is a safe rescue therapy in severe COVID‐19 with associated neurological manifestations and thromboinflammation. AbstractPeripheral neuropathies including Guillain ‐Barré syndrome may be linked to life‐threatening COVID‐19. Plasma exchange is a safe rescue therapy in severe COVID‐19 with associated neurological manifestations and thromboinflammation.
Source: Clinical Case Reports - Category: General Medicine Authors: Tags: CASE REPORT Source Type: research
AbstractObjectivesEvidences from either small series or spontaneous reporting are accumulating that SARS-CoV-2 involves the Nervous Systems. The aim of this study is to provide an extensive overview on the major neurological complications in a large cohort of COVID-19 patients.MethodsRetrospective, observational analysis on all COVID-19 patients admitted from February 23rd to April 30th, 2020 to ASST Papa Giovanni XXIII, Bergamo, Italy for whom a neurological consultation/neurophysiological assessment/neuroradiologic investigation was requested. Each identified neurologic complication was then classified into main neurolog...
Source: Journal of Neurology - Category: Neurology Source Type: research
In conclusion, our study suggests that SARS-CoV-2 antibodies need to be searched in the serum and CSF in patients with GBS living in endemic areas, even in the absence of a clinically severe COVID- 19 infection, and that IL-8 pathway can be relevant in Si-GBS pathogenesis. Further studies are needed to conclude on the relevance of the genetic findings, but it is likely that HLA plays a role in this setting as in other autoimmune neurological syndromes, including those triggered by infections.
Source: Neurological Sciences - Category: Neurology Source Type: research
HORSHAM, PA, September 30, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today that the U.S. Food and Drug Administration (FDA) has approved SIMPONI ARIA® (golimumab) for patients 2 years of age and older for the treatment of active pJIA and has extended the PsA indication for this same patient population. “This latest FDA approval of SIMPONI ARIA for pediatric use in active pJIA and active PsA not only brings a new option to young patients living with these diseases but also adds to the growing body of evidence for this treatment,” said Mathai Mammen, M.D., Ph.D., Glob...
Source: Johnson and Johnson - Category: Pharmaceuticals Source Type: news
About 30% of patients with Guillain-Barr é syndrome become ventilator dependent, of whom roughly 75% develop pneumonia. This trial aimed at assessing the impact of early mechanical ventilation (EMV) on pneumoni...
Source: Annals of Intensive Care - Category: Intensive Care Authors: Tags: Research Source Type: research
We report a 25 years-old male patient with GBS who underwent consecutive EP (n = 11) during his ICU stay over a period of 11 weeks. The series of tests performed in this patient (and corresponding clinical events) show that EP data might represent an approximation of vagal dysfunction and vagal recovery in GBS. Interestingly, we observed a much longer duration of pathological EP compared to a previous report. The tenacious cardiac dysautonomia in this patient necessitated long-term application of a transvenous temporary pacemaker.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
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