Guillain-Barre syndrome associated with leptomeningeal enhancement following SARS-CoV-2 infection

被引:54
作者
Sancho-Saldana, Agustin [1 ]
Lambea-Gil, Alvaro [1 ]
Capablo Liesa, Jose Luis [1 ]
Barrena Caballo, Maria Rosario [2 ]
Haddad Garay, Maria [3 ]
Rivero Celada, David [4 ]
Serrano-Ponz, Marta [1 ]
机构
[1] Hosp Univ Miguel Servet, Neurol, Zaragoza, Spain
[2] Hosp Univ Miguel Servet, Neuroradiol, Zaragoza, Spain
[3] Hosp Univ Miguel Servet, Clin Neurophysiol, Zaragoza, Spain
[4] Hosp Univ Miguel Servet, Neurosurg, Zaragoza, Spain
关键词
COVID-19; SARS-CoV-2; Guillain-Barre syndrome; leptomeningeal enhancement; coronavirus;
D O I
10.7861/clinmed.2020-0213
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction Patients with coronavirus disease 2019 (COVID-19) typically present with respiratory symptoms, but little is known about the disease's potential neurological complications. We report a case of Guillain-Barre syndrome (GBS) following a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, in association with leptomeningeal enhancement. Case presentation A 56-year-old woman presented with recent unsteadiness and paraesthesia in both hands. Fifteen days earlier, she complained of fever, dry cough and shortness of breath. Her chest X-ray showed a lobar consolidation and PCR was positive for SARS-CoV-2; she was admitted due to mild COVID-19 pneumonia. In the first 48 hours of hospitalisation, she started to experience lumbar pain and weakness of the proximal lower extremities, progressing to bilateral facial nerve palsy, oropharyngeal weakness and severe proximal tetraparesis with cervical flexion 2/5 on the MRC scale. Full spine magnetic resonance imaging (MRI) showed a brainstem and cervical leptomeningeal enhancement. Analysis of cerebrospinal fluid (CSF) revealed albumin-cytological dissociation. Microbiological studies on CSF, including SARS-CoV-2, were negative. Nerve conduction studies were consistent with demyelinating neuropathy. She was treated with intravenous immunoglobulin, with significant neurological improvement noted over the next 2 weeks. Conclusion Leptomeningeal enhancement is an atypical feature in GBS, but could be a marker of its association with SARS-CoV-2 infection.
引用
收藏
页码:E93 / E94
页数:2
相关论文
共 8 条
[1]  
[Anonymous], 2018, NEURONEUROSURG
[2]  
Chen S, 2020, JAMA Neurol, DOI [10.1101/2020.02.22.20026500, 10.1001/jamaneurol.2020.1127]
[3]   Neurologic Features in Severe SARS-CoV-2 Infection [J].
Helms, Julie ;
Meziani, Ferhat .
NEW ENGLAND JOURNAL OF MEDICINE, 2020, 382 (23) :2268-2270
[4]   Neurological Complications during Treatment of Middle East Respiratory Syndrome [J].
Kim, Jee-Eun ;
Heo, Jae-Hyeok ;
Kim, Hye-Ok ;
Song, Sook-Hee ;
Park, Sang-Soon ;
Park, Tai-Hwan ;
Ahn, Jin-Young ;
Kim, Min-Ky ;
Choi, Jae-Phil .
JOURNAL OF CLINICAL NEUROLOGY, 2017, 13 (03) :227-233
[5]   Guillain-Barre Syndrome Associated with SARS-CoV-2 [J].
Toscano, Gianpaolo ;
Palmerini, Francesco ;
Ravaglia, Sabrina ;
Ruiz, Luigi ;
Invernizzi, Paolo ;
Cuzzoni, M. Giovanna ;
Franciotta, Diego ;
Baldanti, Fausto ;
Daturi, Rossana ;
Postorino, Paolo ;
Cavallini, Anna ;
Micieli, Giuseppe .
NEW ENGLAND JOURNAL OF MEDICINE, 2020, 382 (26) :2574-2576
[6]   Guillain-Barre syndrome [J].
Willison, Hugh J. ;
Jacobs, Bart C. ;
van Doorn, Pieter A. .
LANCET, 2016, 388 (10045) :717-727
[7]   Nervous system involvement after infection with COVID-19 and other coronaviruses [J].
Wu, Yeshun ;
Xu, Xiaolin ;
Chen, Zijun ;
Duan, Jiahao ;
Hashimoto, Kenji ;
Yang, Ling ;
Liu, Cunming ;
Yang, Chun .
BRAIN BEHAVIOR AND IMMUNITY, 2020, 87 :18-22
[8]   Guillain-Barre syndrome associated with SARS-CoV-2 infection: causality or coincidence? [J].
Zhao, Hua ;
Shen, Dingding ;
Zhou, Haiyan ;
Liu, Jun ;
Chen, Sheng .
LANCET NEUROLOGY, 2020, 19 (05) :383-384