Psychiatric Sequelae of Guillain-Barré Syndrome: Towards a Multidisciplinary Team Approach

Hillyar, Christopher; Nibber, Anjan

doi:10.7759/cureus.7051

Cited by 11 publications

(12 citation statements)

References 47 publications

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“…Additionally, the expansion of setting-adapted training will be important to improve the ICU performance of ventilated patients under treatment. Psychiatrists are sometimes consulted to solve psychiatric symptoms like anxiety, stress, depression, and visual hallucination ( Hillyar and Nibber, 2020 ).…”

Section: Supportive Care and Treatment In The Intensive Care Unitmentioning

confidence: 99%

“…High-intensity multidisciplinary ambulatory rehabilitation up to 12 months can effectively reduce disability of GBS patients at the later stages of recovery and improve the quality of life ( Khan and Amatya, 2012 ). It is noteworthy that GBS patients after discharge may be left with psychiatric sequelae including stress, anxiety, depression, fatigue, sleep abnormalities, and visual hallucinations, which may need a multidisciplinary team approach to facilitate both physical and psychiatric recovery ( Hillyar and Nibber, 2020 ). Although early rehabilitation is necessary for preventing ICUAW and facilitating the recovery of axonal GBS, it remains unclear, however, whether exercise-based rehabilitation, neurotrophic therapies, or acupuncture in general wards and after hospital discharge is beneficial ( Lee et al, 2015 ; Shang et al, 2020a ; Fan et al, 2020 ).…”

Section: Supportive Care and Treatment In The Intensive Care Unitmentioning

confidence: 99%

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Intensive Care and Treatment of Severe Guillain–Barré Syndrome

Shang

Feng

et al. 2021

Front. Pharmacol.

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Guillain–Barré syndrome (GBS) is an acute polyneuropathy mostly characterized by acute flaccid paralysis with or without sensory/autonomous nerve dysfunction. Current immuno therapies including intravenous immunoglobulin (IVIg), plasma exchange (PE), and newly developed biological drugs benefit patients by alleviating hyperreactive immune responses. Up to 30% of patients develop respiratory failure during hospitalization and require mechanical ventilation and intensive care. Immunotherapies, mechanical ventilation, supportive care, and complication management during the intensive care unit (ICU) stay are equally emphasized. The most important aspect of intensive care and treatment of severe GBS, that is, mechanical ventilation, has been extensively reviewed elsewhere. In contrast to immunotherapies, care and treatment of GBS in the ICU setting are largely empirical. In this review, we intend to stress the importance of intensive care and treatment, other than mechanical ventilation in patients with severe GBS. We summarize the up-to-date knowledge of pharmacological therapies and ICU management of patients with severe GBS. We aim to answer some key clinical questions related to the management of severe GBS patients including but not limited to: Is IVIg better than PE or vice versa? Whether combinations of immune therapies benefit more? How about the emerging therapies promising for GBS? When to perform tracheal intubation or tracheostomy? How to provide multidisciplinary supportive care for severe cases? How to avert life-threatening complications in severe cases?

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Section: Supportive Care and Treatment In The Intensive Care Unitmentioning

confidence: 99%

Section: Supportive Care and Treatment In The Intensive Care Unitmentioning

confidence: 99%

Intensive Care and Treatment of Severe Guillain–Barré Syndrome

Shang

Feng

et al. 2021

Front. Pharmacol.

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“…These sequelae, particularly pain and fatigue can persist for years, even after recovery is ostensibly complete (Hillyer & Nibber, 2020; Merkies et al., 1999; Ranjani et al., 2014). This persistence might signal injury (Merkies & Kieseier, 2016), an assertion supported by the findings of this present study which suggests residual injuries, insufficiencies precipitated by compensatory movements, may develop over time.…”

Section: Discussionmentioning

confidence: 99%

Falls in people post‐Guillain‐Barré syndrome in the United Kingdom: A national cross‐sectional survey of community based adults

Davidson

Parker

2022

Health Social Care Comm

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Guillain-Barré syndrome is a demyelinating peripheral neuropathy with an incidence of between 0.8 and 1.9/100,000 people in Europe and North America (Willison et al., 2016) affecting all age groups, with males and older aged individuals more affected (Hughes & Cornblath, 2005). Heterogeneity of severity ranges from short-lived limb paraesthesia to complete paralysis requiring prolonged mechanical ventilation (van Koningsveld et al., 2007). Although generally viewed as restorative, around 20% of people with GBS remain disabled (Hughes & Cornblath, 2005). Between 3% and 7% die in de-

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“…Hallucination was found in 11% of patients, including visual as well as auditory types, and was related to delirium or more probably neuroinflammatory process [12]. On the other hand, it was not unusual to note the onset of psychiatric symptoms during acute phase of GBS, although it might be interpreted as intensive care unit (ICU) delirium [13]. ese symptoms included visual hallucinations, paranoid delusions, disorientation, and psychosis [13].…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, it was not unusual to note the onset of psychiatric symptoms during acute phase of GBS, although it might be interpreted as intensive care unit (ICU) delirium [13]. ese symptoms included visual hallucinations, paranoid delusions, disorientation, and psychosis [13]. Risk factors were autonomic dysfunction, assisted ventilation, and high CSF protein [13].…”

Section: Discussionmentioning

confidence: 99%

Guillain–Barré Syndrome Associated with COVID-19: Two Cases from a Public Hospital in Damascus, Syria

Ahmad¹,

Hamdan²,

Saadeh

2022

Case Reports in Medicine

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Objective. To report two cases of COVID-19 complicated with Guillain–Barré syndrome (GBS) from a public hospital in Damascus, Syria. Results. Two unvaccinated patients, 49-year-old and 34-year-old men, presented with a history of paresthesia followed by ascending symmetric weakness with absent tendon reflexes. They were diagnosed with coronavirus disease 2019 (COVID-19) using chest CT and RT-PCR. Clinical status and lumbar puncture (LP) findings were consistent with GBS. They were treated with plasma exchange (PE). However, the first patient developed hallucinations and later deteriorated. He passed away after the second session of PE, while the second patient had four sessions of plasma exchange and was later discharged for home rehabilitation. Conclusion. It is important to consider GBS in COVID-19 patients who present with acute ascending weakness or cranial nerves involvement. More studies are needed to evaluate correlation between COVID-19, GBS, and development of psychiatric disturbances besides investigating the discrepancy between lung parameters and respiratory failure.

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Psychiatric Sequelae of Guillain-Barré Syndrome: Towards a Multidisciplinary Team Approach

Cited by 11 publications

References 47 publications

Intensive Care and Treatment of Severe Guillain–Barré Syndrome

Intensive Care and Treatment of Severe Guillain–Barré Syndrome

Falls in people post‐Guillain‐Barré syndrome in the United Kingdom: A national cross‐sectional survey of community based adults

Guillain–Barré Syndrome Associated with COVID-19: Two Cases from a Public Hospital in Damascus, Syria

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