Prediction of Functional Outcome in Axonal Guillain-Barre Syndrome

Sung, Eun Jung; Kim, Dae Yul; Lee, Hee Jin; Ko, Euihong

doi:10.5535/arm.2016.40.3.481

Cited by 9 publications

(12 citation statements)

References 32 publications

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“…However, studies on most CSF proteins are less, the numbers of patients are small. 19 We aimed to find out an easy and inexpensive prognostic marker for inflammatory polyneuropathies using the data obtained from routine clinical evaluation. Overall, we found a relationship between increased CSF protein levels with poor prognosis but plasma high NLR with good prognosis in GBS patients.…”

Section: Discussionmentioning

confidence: 99%

Are cerebrospinal fluid protein levels and plasma neutrophil/lymphocyte ratio associated with prognosis of Guillain Barré syndrome?

2017

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Guillain Barré syndrome (GBS) is a post-infectious acute autoimmune polyradiculopathy. Cerebrospinal fluid (CSF) total protein level and plasma neutrophil/lymphocyte ratio (NLR) are related with autoimmune response. We aimed to reach a prognostic indicator for GBS by using electrophysiological findings, protein level of CSF, and plasma NLR based on Medical Research Council (MRC) sum score data. Cases who met diagnostic criteria of GBS and followed at least six months were enrolled in the study. Nerve conduction study (NCS) and lumbar puncture were performed one week after symptom onset. Routine CSF findings and complete blood count were recorded. Plasma NLR was calculated as the ratio of neutrophil cell count to lymphocyte cell count. All patients received intravenous immunoglobulin. MRC sum scores were calculated on administration time (1st) and six months later (2nd) for evaluation of recovery. Mean values of baseline CSF protein level, NCS parameters and NLR were compared with mean scores of MRC1st and MRC2nd. Increased CSF protein levels showed negative correlation with MRC2nd scores but no correlation with NCS. Increased NLR levels were positively correlated with age, MRC2nd scores and NCS. Facial diplegia was observed in 42% of patients. A positive correlation was found between high level of NLR and MRC1st, and there was no relationship with MRC2nd. Regression analyses showed that only CSF protein level was an independent factor on both MRC1st and MRC2nd. A positive association was found between baseline data included young age high plasma NLR, low level of CSF protein and good prognosis in our study. Also a positive correlation was found between high level of NLR and baseline disability in GBS cases with facial diplegia. Calculation of NLR is an easy and inexpensive method. On the other hand it may be influenced by age and immunotherapy. Our results showed that CSF protein level is still a liable parameter for prognosis. NLR could be a candidate prognostic marker of GBS cases. Further investigations including more cases are needed.

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Section: Discussionmentioning

confidence: 99%

Are cerebrospinal fluid protein levels and plasma neutrophil/lymphocyte ratio associated with prognosis of Guillain Barré syndrome?

2017

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“…1). Depending on the nature of the damage, an individual may experience either the demyelinating or axonal GBS subtype, which not only differ in the symptom manifestations but also in the likelihood of recovery [20].…”

Section: Introductionmentioning

confidence: 99%

COVID-19-Associated Guillain-Barre Syndrome: Atypical Para-infectious Profile, Symptom Overlap, and Increased Risk of Severe Neurological Complications

Kajumba

Kolls

Koltai

et al. 2020

SN Compr. Clin. Med.

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The concurrence of COVID-19 with Guillain-Barre syndrome (GBS) can increase the likelihood of neuromuscular respiratory failure, autonomic dysfunction, and other life-threatening symptoms. Currently, very little is known about the underlying mechanisms, clinical course, and prognostic implications of comorbid COVID-19 in patients with GBS. We reviewed COVID-19associated GBS case reports published since the outbreak of the pandemic, with a database search up to August 2020, including a manual search of the reference lists for additional relevant cases. Fifty-one (51) case reports of COVID-19 patients (aged 23-84 years) diagnosed with GBS in 11 different countries were included in this review. The results revealed atypical manifestations of GBS, including para-infectious profiles and onset of GBS without antecedent COVID-19 symptoms. Although all tested patients had signs of neuroinflammation, none had SARS-CoV-2 in the cerebrospinal fluid (CSF), and only four (4) patients had antiganglioside antibodies. The majority had a 1-to 10-day time interval between the onset of COVID-19 and GBS symptoms, and many had a poor outcome, with 20 out of the 51 (39.2%) requiring mechanical ventilation, and two deaths within 12 to 24 h. The atypical manifestations of COVID-19-associated GBS, especially the para-infectious profile and short time interval between the onset of the COVID-19 and GBS symptoms, increase the likelihood of symptom overlap, which can complicate the treatment and result in worsened disease progression and/or higher mortality rates. Inclusion of a neurological assessment during diagnosis of COVID-19 might facilitate timely identification and effective management of the GBS symptoms and improve treatment outcome.

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“…The course of disease is similar to the classical GBS, but more severe and prolonged with frequent ventilator dependency, slow recovery and significant residues. 2 – 8 The therapy of AMAN and AMSAN is based on that of the acute inflammatory demyelinating polyradiculoneuropathy (AIDP), 9 that is, plasma exchange (PLEX) and intravenous immunoglobulin (IVIG), while the benefit of corticosteroids remains ambiguous. 2 …”

Section: Introductionmentioning

confidence: 99%

Treatment of an acute motor and sensory axonal neuropathy with propionate in a 33-year-old male

Yoon

Pitarokoili

Sturm

et al. 2018

Ther Adv Neurol Disord

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Background:The aim of this work was to report a case of an acute motor and sensory axonal neuropathy (AMSAN) treated with propionate to evaluate its therapeutic potential in AMSAN.Materials and methods:The patient was investigated by clinical examination, electroneurography, high-resolution nerve ultrasound and confocal corneal microscopy at baseline and the 2 month follow up. We compared the outcome with those of five other patients with acute motor axonal neuropathy (AMAN) and AMSAN of who were referred to our neurology department in the past 5 years.Results:Considering the poor prognosis of patients with acute axonal neuropathies and in comparison with the previously treated patients with AMAN or AMSAN in our clinic, the regression of our patient’s symptoms and the improvement in the additional examinations under propionate seemed exceptionally good.Conclusion:Propionate may have an additional therapeutic effect in autoimmune inflammatory neuropathies.

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Prediction of Functional Outcome in Axonal Guillain-Barre Syndrome

Cited by 9 publications

References 32 publications

Are cerebrospinal fluid protein levels and plasma neutrophil/lymphocyte ratio associated with prognosis of Guillain Barré syndrome?

Are cerebrospinal fluid protein levels and plasma neutrophil/lymphocyte ratio associated with prognosis of Guillain Barré syndrome?

COVID-19-Associated Guillain-Barre Syndrome: Atypical Para-infectious Profile, Symptom Overlap, and Increased Risk of Severe Neurological Complications

Treatment of an acute motor and sensory axonal neuropathy with propionate in a 33-year-old male

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