Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

Síndrome de Guillaín-Barré

 

Valoración por Ultrasonido del Nervio Vago en el Síndrome de Guillain-Barré: A Propósito de un Caso Clínico

Introduction: In Guillain-Barré Syndrome (GBS), an increased cross-sectional area (CSA) of the vagus nerve (VN) has been described as a diagnostic tool and as an indicator of autonomic dysfunction.

Methods and Objectives: With the presentation of a GBS case, we aim to describe the technique for assessing the CSA of the VN using ultrasound (US).

Results: The evaluation of the VN CSA by US is a diagnostic technique with several advantages for clinicians. CSA values greater than 3 mm² are associated with the demyelinating variant of GBS and a higher likelihood of autonomic dysfunction.

Conclusion: The assessment of VN CSA by US is a useful tool in the diagnostic approach to patients with suspected GBS.

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Palabras clave: diagnóstico por imagen, Nervio vago, Síndrome de Guillaín-Barré, Sistema Nervioso Autónomo, Ultrasonografía,

Keywords: Autonomic Nervous System, diagnostic imaging, Guillain Barre syndrome, Ultrasonography, Vagus Nerve,

Síndrome de Guillain-Barré como Complicación del Golpe de Calor. Guillain-Barré Syndrome As A Complication Of Heatstroke

Madam Editor:
Heatstroke (HS) is a medical emergency characterized by a body temperature above 40ºC and the development of neurological alterations such as delirium, seizures, or coma. HS may result from excessive exposure to environmental heat (classic HS) or from strenuous physical exertion.¹ Several factors have been identified that increase susceptibility to HS, including extreme ages of life, medical comorbidities (infections, fever, skin disorders, or cardiovascular insufficiency), the use of certain medications (diuretics, beta-blockers, antihistamines, and antidepressants), or alcohol consumption.

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Palabras clave: golpe de calor, Guillain Barré, Síndrome de Guillaín-Barré,

Keywords: Guillaín-Barré síndrome, heatstroke,

Síndrome de Guillain Barré asociado a infección por SARS-CoV-2. Guillain-Barré Syndrome Associated with SARS-CoV-2 infection.

Guillain-Barré Syndrome (GBS) is an uncommon but potentially serious clinical entity characterized by symmetric, rapidly progressive limb weakness, reduced or absent deep tendon reflexes, and paresthesias. This case report discusses a 23-year-old male with a history of SARS-CoV-2 infection, presenting with paresthesias, weakness in the thighs, and walking difficulty.

Physical examination exhibited asymmetric facial diplegia, right sixth cranial nerve palsy, flaccid quadriparesis with predominant crural involvement, and generalized areflexia.

Electrophysiological studies, practiced within the first week, revealed absent H reflex and delayed distal motor latencies. Additionally, concentric needle examination showed no abnormal activity at rest, with a pattern of poor recruitment of motor units with normal morphology. The cerebrospinal fluid analysis showed albumin-cytological dissociation. Intravenous immunoglobulin therapy was initiated, resulting in gradual neurological stabilization, and the patient was discharged with a Rankin score of 4/5.

Follow-up evaluations showed improvement in motor symptoms, and after six months, the patient fully reintegrated into normal life. This case emphasizes the association between GBS and prior COVID-19 infection, highlighting the importance of neurological monitoring during convalescence.

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Palabras clave: complicaciones neurológicas, COVID-19, inmunoglobulina intravenosa, Síndrome de Guillaín-Barré,

Keywords: COVID-19, Guillain Barre syndrome, intravenous immunoglobulin, neurological complications,

Perspectiva histórica y actualidad de los síndromes antigangliósidos. Historical perspective and current scenarios of the antiganglioside syndrome

The antiganglioside syndromes constitute a large clinical spectrum. Its knowlegde has evolved from the classical pure clinical descriptions to a wide development of the immunopathology underlying these processes and its possibilities of treatment.

In this work we realize a bibliographical review analyzing its evolution from a historical perspective to date at four levels: clinical, topographic, immunologic, and therapeutic. We analyze critically well-known topographical and immunologic notions that are scarcely integrated in daily clinical practice. We debate about the need of establish a new nomenclature for these syndromes in two levels: clinical and immunologic. Finally, we review the current and under development therapeutic lines.

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Palabras clave: Gangliósidos, Inmunopatología, Nodopatías, Polineurorradiculopatía aguda, Síndrome de Bickerstaff, Síndrome de Guillaín-Barré, Síndrome de Miller-Fisher,

Keywords: Acute polyneuroradiculopathy, Bickerstaff syndrome, Gangliosides, Guillain Barre syndrome, Immunopathology, Miller-Fisher syndrome, Nodopathies,

Características Clínicas del Síndrome de Guillain-Barré en Relación a Chikungunya Y Zika: Revisión Sistemática. Clinical Manifestations Of Guillain-Barre Syndrome And Its Relation To Chikungunya And Zika.

In the last five years, there have been several cases of zika and chikungunya infections in the world, simultaneous with the increase in cases of Guillain-Barre syndrome, which have shown a potential causal relationship that is still not entirely clear. Objective: To describe the main clinical manifestations of Guillain-Barre syndrome in relation to chikungunya and zika, according to scientific literature. Methods: The databases PubMed and ScienceDirect were used to perform the search for the period 2014-2016 using with the keywords: zika, chikungunya and Guillain-Barre Syndrome; articles in English and Spanish were included. Results: 35 articles were found, one for the year 2014, two for 2015 and 32 for 2016. Conclusion: Variations in clinical characteristics and the increased incidence of GBS in the presence of zika and chikungunya, highlight the need to monitor these infections and perform analytic studies to determine the association between arboviruses and different neurological alterations.

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Palabras clave: Arbovirus, Infecciones por Arbovirus, Síndrome de Guillaín-Barré,

Keywords: Arbovirus Infections, Arboviruses, Guillain Barre syndrome,

Síndrome de Guillain Barré: Reporte de un Caso Causado por Enterovirus. Guillain Barre Syndrome: Report Of a Case Caused By Enterovirus.

Guillain Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy of autoimmune etiology  that is usually preceded by a respiratory or gastrointestinal infection. It is characterized by a flaccid, symmetric, ascendent, arreflexic paralysis of rapid evolution. We describe a case of a 33 years old male patient, with a history of flu two weeks before admission, in addition to liquid stools that reverted spontaneously; his  clinical picture consisted of a six days history of cuadriparesis aggravated by respiratory weakness, ending in mechanical ventilation. Examination of cerebrospinal fluid (CSF) revealed albumino-cytological disociation and PCR test resulted positive for Enterovirus. The patient received treatment with intravenous immunoglobulin with a favorable outcome. The purpose of this paper is to report a clinical case of GBS due to a new causal agent.

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Palabras clave: Enterovirus, Polirradiculoneuropatía, Síndrome de Guillaín-Barré,

Keywords: Enterovirus, Guillain Barre syndrome, Polirradiculoneuropathy,

Dolor en Síndrome de Guillain Barré: Una Manifestación Subestimada. Pain In Guillain Barré Syndrome: An Underestimated Manifestation.

Guillain-Barré syndrome is an acute demyelinating polyneuropathy that presents clinically with muscular weakness and autonomic disorders in its typical form, while the sensory symptoms usually go unnoticed.

We describe the clinical history of a male patient with acute flaccid quadriparesis and sensory disorders such as paresthesia and allodynia that hinder diagnosis within the initial approach.

Complete diagnostic work up confirmed the presence of Guillain-Barré syndrome. Although the sensory symptoms confused the diagnosis during admission, it is important to highlight that pain is a frequent manifestation of this disorder, being underestimated in many patients.

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Palabras clave: alodinia, atípico, dolor, Síndrome de Guillaín-Barré,

Keywords: allodynia, atypical, Guillaín-Barré síndrome, pain,
 
 
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