Zika virus infection and Guillain-Barré syndrome: a review focused on clinical and electrophysiological subtypes

Abstract

In 2016, we have seen a rapid emergence of Zika virusassociated Guillain-Barré syndrome (GBS) since its first description in a French-Polynesian patient in 2014. Current evidence estimates the incidence of GBS at 24 cases per 100 000 persons infected by Zika virus. This will result in a sharp rise in the number of GBS cases worldwide with the anticipated global spread of Zika virus. A better understanding of the pathogenesis of Zika-associated GBS is crucial to prepare us for the current epidemic. In this review, we evaluate the existing literature on GBS in association with Zika and other flavivirus to better define its clinical subtypes and electrophysiological characteristics, demonstrating a demyelinating subtype of GBS in most cases. We also recommend measures that will help reduce the gaps in knowledge that currently exist.

Clinical and nerve conduction features in Guillain−Barré syndrome associated with Zika virus infection in Cúcuta, Colombia

“…In conclusion GBS associated with ZIKV infection in Cúcuta shows an aggressive and severe course and is mostly demyelinating in nature just as GBS associated with other flavivirus infections . Extensive data acquisition and, when possible, serial studies are recommended for a better understanding of the pathogenesis of GBS associated with ZIKV infection through electrophysiology.…”

Zika Virus: An Emerging Worldwide Threat

“…Numerous case studies in the French Polynesia have determined the relationship between GBS and ZIKV (De Oliveira et al, 2017), where GBS is a disorder of the immune system that is characterized by sensory abnormalities, autonomic dysfunction, and weakness due to nerve root orperipheral damage (Dirlikov et al, 2017). During the ZIKV outbreaks, record numbers of patients were found to have GBS (Uncini et al, 2016) Subcutaneous bleeding and hematospermia were other symptoms associated with GBS followed by ZIKV syndrome (Lyle et al, 2016). According to European Center for Disease Prevention and Control [ECDC] (2016), the data of French Polynesia outbreak hints a possible link between GBS and ZIKV, which was later validated by French Ministry of Health in Martinique.…”

Postmortem Findings in Patient with Guillain-Barré Syndrome and Zika Virus Infection

“…Consistent with the patient’s electromyography results, histopathologic observation of demyelination of sciatic and cranial IV nerves provides phenotypic evidence of the acute demyelinating inflammatory polyneuropathy GBS variant. Although results from French Polynesia and Colombia found the acute motor axonal neuropathy variant ( 3 , 9 ), elsewhere, the acute demyelinating inflammatory polyneuropathy variant has predominated among GBS patients with evidence of Zika virus infection ( 14 ). Demyelination of both sciatic and cranial IV nerves is consistent with reported clinical signs of GBS patients with evidence of Zika virus infection.…”