Guillain-Barré syndrome related to SARS-CoV-2 infection

Bigaut, Kévin; Mallaret, Martial; Baloglu, Seyyid; Némoz, Benjamin; Morand, Patrice; Baicry, Florent; Godon, Alexandre; Voulleminot, Paul; Kremer, Laurent; Chanson, Jean‐Baptiste; Sèze, Jérôme De

doi:10.1212/nxi.0000000000000785

Cited by 92 publications

(94 citation statements)

References 5 publications

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“…Most patients in this study had isolated facial palsy with mild or moderate dysfunction and no other neurological findings. Except for the two described above by Goh and Casas (Casas et al 2020;Goh et al 2020), in all other studies, facial paralysis in COVID-19 patients occurred unilaterally or bilaterally in association with other manifestations of Guillain-Barré syndrome (Manganotti et al 2020;Ottaviani et al 2020;Juliao Caamaño and Alonso Beato 2020;Paybast et al 2020;Sancho-Saldaña et al 2020;Bigaut et al 2020).…”

Section: Discussionmentioning

confidence: 79%

Peripheral facial nerve palsy associated with COVID-19

et al. 2020

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COVID-19 pandemic revealed several neurological syndromes related to this infection. We describe the clinical, laboratory, and radiological features of eight patients with COVID-19 who developed peripheral facial palsy during infection. In three patients, facial palsy was the first symptom. Nerve damage resulted in mild dysfunction in five patients and moderate in three. SARS-Cov-2 was not detected in CSF by PCR in any of the samples. Seven out of eight patients were treated with steroids and all patients have complete or partial recovery of the symptoms. Peripheral facial palsy should be added to the spectrum of neurological manifestations associated with COVID-19.

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Section: Discussionmentioning

confidence: 79%

Peripheral facial nerve palsy associated with COVID-19

et al. 2020

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“…Usual MRI ndings in these patients included facial nerve contrast enhancement [43]. Similarly, in some patients with GBS and cranial nerve impairment, III, VI, VII, and VIII contrast enhancement in MRI was evident [44]. Finally, some authors reported compromise of low cranial nerves among patients with COVID-19, including dysphagia as part of GBS [47], isolated dysphagia [48], and hypoglossal de cit due to rhombencephalitis [49].…”

Section: Cranial Nerve Impairmentmentioning

confidence: 92%

“…Uni or bilateral abducens' involvement associated with COVID-19 has been described [41,42]. MRI studies con rmed nerve enhancement in some of them [43,44]. Facial nerve compromise by SARS-CoV-2 can occur in isolation [45] or as part of peripheral neuropathy like Guillain-Barre syndrome (GBS) [46].…”

Section: Cranial Nerve Impairmentmentioning

confidence: 99%

“…Variable sensory abnormalities have also been described [12]. Nerve conduction and electromyography studies carried out in 16 patients with GBS and COVID-19 reported acute in ammatory demyelinating polyneuropathy in 12 cases [44,47,[73][74][75][76][77][78][79][80], sensory-motor axonal neuropathy in 3 cases [73,81], and acute motor axonal neuropathy in 1 case [7]. Three patients with GBS presented enhancement of the caudal nerve roots on spine MRI [72,73].…”

Section: Peripheral Neuropathiesmentioning

confidence: 99%

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Central and peripheral nervous system involvement by COVID-19: A systematic review of the pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings

Guerrero

Barragán

Martinez

et al. 2020

Preprint

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Background: SARS-CoV-2 can affect the human brain and other neurological structures. An increasing number of publications report neurological manifestations in patients with COVID-19. However, no studies have comprehensively reviewed the clinical and paraclinical characteristics of the central and peripheral nervous system's involvement in these patients. This study aimed to describe the features of the central and peripheral nervous system involvement by COVID-19 in terms of pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings.Methods: We conducted a comprehensive systematic review of all the original studies reporting patients with neurological involvement by COVID-19, from December 2019 to June 2020, without language restriction. We excluded studies with animal subjects, studies not related to the nervous system, and opinion articles. Data analysis combined descriptive measures, frequency measures, central tendency measures, and dispersion measures for all studies reporting neurological conditions and abnormal ancillary tests in patients with confirmed COVID-19.Results: A total of 143 observational and descriptive studies reported central and peripheral nervous system involvement by COVID-19 in 10723 patients. Fifty-one studies described pathophysiologic mechanisms of neurological involvement by COVID-19, 119 focused on clinical manifestations, 4 described neuropathology findings, 62 described neuroimaging findings, 28 electrophysiology findings, and 60 studies reported cerebrospinal fluid results. The reviewed studies reflect a significant prevalence of the nervous system's involvement in patients with COVID-19, ranging from 22.5% to 36.4% among different studies, without mortality rates explicitly associated with neurological involvement by SARS-COV-2. We thoroughly describe the clinical and paraclinical characteristics of neurological involvement in these patients. Conclusions: Our evidence synthesis led to a categorical analysis of the central and peripheral involvement by COVID-19 and provided a comprehensive explanation of the reported pathophysiological mechanisms by which SARS-CoV-2 infection may cause neurological impairment. International collaborative efforts and exhaustive neurological registries will enhance the translational knowledge of COVID-19's CNS and PNS involvement and generate strategies for therapeutic decision-making.Registration: This review is registered in PROSPERO (CRD42020193140), July 24, 2020.

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“…Overall 30 cases of GBS variants have been reported worldwide in patients with confirmed COVID-19 since the pandemic ( Table 2 ), with mostly typical manifestation of rapidly progressive flaccid limbs weakness and areflexia, with and without facial muscle weakness, and distal paresthesia or numbness. Cranial nerve involvements have been observed in 5 (17%) cases ( Bigaut et al, 2020 ; Gutiérrez-Ortiz et al, 2020 ; Reyes-Bueno et al, 2020 ; Sancho-Saldaña et al, 2020 ). Either unilateral or bifacial weakness was present in 12 (40%) cases.…”

Section: Neurologic Manifestationsmentioning

confidence: 99%

SARS-CoV-2 and nervous system: From pathogenesis to clinical manifestation

Keyhanian

Umeton

Mohit

et al. 2021

Journal of Neuroimmunology

113

139

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Since the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a growing body of evidence indicates that besides common COVID-19 symptoms, patients may develop various neurological manifestations affecting both the central and peripheral nervous systems as well as skeletal muscles. These manifestations can occur prior, during and even after the onset of COVID-19 general symptoms. In this Review, we discuss the possible neuroimmunological mechanisms underlying the nervous system and skeletal muscle involvement, and viral triggered neuroimmunological conditions associated with SARS-CoV-2, as well as therapeutic approaches that have been considered for these specific complications worldwide.

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Guillain-Barré syndrome related to SARS-CoV-2 infection

Cited by 92 publications

References 5 publications

Peripheral facial nerve palsy associated with COVID-19

Peripheral facial nerve palsy associated with COVID-19

Central and peripheral nervous system involvement by COVID-19: A systematic review of the pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings

SARS-CoV-2 and nervous system: From pathogenesis to clinical manifestation

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