Altered mental status in “Guillain‐Barré syndrome” –a noteworthy clinical clue

Mulroy, Eoin; Anderson, Neil E.

doi:10.1002/acn3.51226

Cited by 4 publications

(4 citation statements)

References 109 publications

(233 reference statements)

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“…However, there are few reports of polyuria and transient diabetes insipidus in GBS. [ 1 , 6 - 9 ] In the case reports, patients were managed by either injection vasopressin/nasal desmopressin; however, in our case, it was resolved spontaneously. The excellent temporal relationship of development and correction of polyuria with the start and gradual stop of glycopyrrolate, respectively, supports our claim that polyuria is attributable to glycopyrrolate.…”

Section: Discussionmentioning

confidence: 64%

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Glycopyrrolate-induced polyuria: An unexpected side effect

Behera

Agarwal

Singh

et al. 2023

JNRP

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Polyuria is urine output exceeding 3 L/d in adults, primarily due to solute and water diuresis. In a hospital setting, mannitol and diuretics commonly lead to polyuria. We have found an interesting association of polyuria with glycopyrrolate; to the best of our knowledge, no case is reported in the literature. Here, we are describing a case of Guillain–Barre Syndrome, which developed polyuria during the hospital stay, which was secondary to glycopyrrolate.

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Section: Discussionmentioning

confidence: 64%

“…Guillain–Barre syndrome (GBS) is a fulminant polyradiculopathy of acute onset manifesting as a rapidly progressing areflexic motor paralysis with dysautonomia, which may be associated with sensory disturbances. [ 1 ]…”

Section: Introductionmentioning

confidence: 99%

Glycopyrrolate-induced polyuria: An unexpected side effect

Behera

Agarwal

Singh

et al. 2023

JNRP

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“…Central nervous system (CNS) involvement is classically excluded from the spectrum of GBS. However, it is not uncommon for GBS to present with an altered mental state [5]. CNS dysfunction in GBS correlates with more severe disease and the chance of requiring assisted ventilation [6].…”

Section: Discussionmentioning

confidence: 99%

“…Autonomic dysfunction is a characteristic feature of GBS and is seen in about two-thirds of all cases. This can cause CNS dysfunction by blood pressure fluctuation [5]. For example, severe hypertension can lead to posterior reversible encephalopathy syndrome (PRES), a condition that can result in seizures, altered mental status, and visual impairment.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Pain Followed by Altered Mental Status: A Rare Presentation of Guillain Barré Syndrome

Shekhar¹,

Harisingani²,

Gupta³

2022

Cureus

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Guillain Barré syndrome (GBS) is an acute inflammatory polyneuropathy with several variants; it usually presents as acute symmetrical muscle weakness with or without bulbar involvement, making it a neurological emergency. In this report, we describe the case of a 39-year-old male who presented with abdominal pain for three days and whose illness became progressively drowsy on the fifth day. Based on clinical assessment, nerve conduction studies, and biochemical, microbiological, and radiological investigations, other causes were ruled out and it was concluded that the patient had hyponatremia secondary to syndrome of inappropriate diuretic hormone secretion (SIADH) due to GBS.Although sensory symptoms like pain or dysaesthesias occurring in the back or extremities are common and may precede motor weakness, abdominal pain remains a very rare presentation of GBS. GBS is usually understood as a "pure" peripheral nervous system disorder but central nervous system (CNS) dysfunction may occur due to metabolic abnormalities (like hyponatremia and CO 2 narcosis) or autonomic dysfunction in GBS, its treatment, or due to GBS itself (Anti-GQ1b disease variant).

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Encephalopathy with Guillain-Barré syndrome: seek a different cause

et al. 2023

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A 30-year-old woman developed symptoms, signs and neurophysiology consistent with Guillain-Barré syndrome and was admitted to the neurosciences intensive care unit owing to respiratory compromise. Here, she received a clonidine infusion for agitation, complicated by a minor hypotensive episode, following which she became unconscious. MR scan of the brain showed changes compatible with hypoxic brain injury. Urinary amino acids showed increased urinary α-ketoglutarate. Genetic testing using whole-exome sequencing identified pathogenic variants in theSLC13A3gene known to be associated with an acute reversible leukoencephalopathy with increased urinary α-ketoglutarate. The case highlights the importance of considering inborn errors of metabolism in cases of unexplained encephalopathy.

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Altered mental status in “Guillain‐Barré syndrome” –a noteworthy clinical clue

Cited by 4 publications

References 109 publications

Glycopyrrolate-induced polyuria: An unexpected side effect

Glycopyrrolate-induced polyuria: An unexpected side effect

Abdominal Pain Followed by Altered Mental Status: A Rare Presentation of Guillain Barré Syndrome

Encephalopathy with Guillain-Barré syndrome: seek a different cause

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