[Source: Journal of Medical Virology, full page: (LINK). Abstract, edited.]
Clinical neurophysiology and cerebrospinal liquor analysis to detect Guillain Barré syndrome and polyneuritis cranialis in COVID‐19 patients: a case series
Paolo Manganotti MD PhD, Giulia Bellavita MD, Laura D’Acunto MD, Valentina Tommasini MD, Martina Fabris MD, Arianna Sartori MD, Lucia Bonzi MD, Alex Buoite Stella PhD, Valentina Pesavento MD
First published: 14 July 2020 | DOI: https://doi.org/10.1002/jmv.26289
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/jmv.26289
We report a case series of 5 patients affected by SARS‐CoV‐2 who developed neurological symptoms, mainly expressing as polyradiculoneuritis and cranial polyneuritis in the two months of COVID‐19 pandemic in a city in the north east of Italy. A diagnosis of Guillain Barré syndrome was made on the basis of clinical presentation, cerebrospinal fluid analysis and electroneurography (ENG). In four of them therapeutic approach included the administration of intravenous immunoglobulin (0.4 gr/kg for 5 days), which resulted in the improvement of neurological symptoms. Clinical neurophysiology revealed the presence of conduction block, absence of F waves, and in two cases significant decrease in amplitude of compound motor action potential cMAP. Four patients presented a mild facial nerve involvement limited to the muscles of the lower face, with sparing of the forehead muscles associated to ageusia. In one patient, taste assessment showed right‐sided ageusia of the tongue, ipsilateral to the mild facial palsy. In three patients we observed albuminocytological dissociation in the cerebrospinal fluid, and notably we found an increase of inflammatory mediators such as the interleukin‐8. Peripheral nervous system involvement after infection with COVID‐19 is possible and may include several signs that may be successfully treated with immunoglobulin therapy.
This article is protected by copyright. All rights reserved.
Keywords: SARS-CoV-2; COVID-19; GBS; Neurology; Italy.