Guillain-Barre Syndrome Publications (8333)
Guillain-Barre Syndrome Publications
We assessed quality of surveillance data in terms of completeness of investigation for each case reported. Forty-three AFP cases in children <15 years were notified; 35 of which were confirmed. Guillain-Barre Syndrome (GBS) accounted for 48.6% (n=17) of AFP notifications. In 2014, the expected annual AFP target rate was reached. This study identified possible under-reporting of AFP paediatric cases in Ireland between 2009-2013. Completeness of investigations has improved over time, but requires further work.
There was slight elevation of protein with no pleocytosis in cerebrospinal fluid. After administration of intravenous immunoglobulin (IVIg), only the titer of antiganglioside antibody to GQ1b was decreased, and she showed rapid improvement in dysphagia, urinary retention and constipation, and slow recovery in ophthalmoplegia and cerebellar ataxia. The elevations of antiganglioside antibodies to GQ1b may be pathologically related to autonomic involvement such as urinary retention and constipation in that IVIg seems to be effective. The present case suggests that GQ1b may also locate in the autonomic nerve that plays bladder and defecation functions, and that incidence of neurological symptoms and the response of treatment may differ according to each GQ1b localization.
The original version of HiMAT was translated into French, cross-culturally adapted and field tested. Patients were recruited from "L'Espoir" Rehabilitation Center. All patients were tested with the HiMAT (range of scores=0 [worst] to 54 [best]). There was one day between 2 tests to avoid fatigue. Two testers independently rated patients. Testers were an experienced physiotherapist and a young physiotherapist (less than 1 year after graduate). Young physiotherapist was trained by a view of the test and the instructions sheet. Internal consistency was investigated with Cronbach alpha. Intraclass correlation coefficients (ICCs) were used for assessing interrater and intrarater reliability (HiMAT sum score and each HiMAT item). Minimal detectable change (MDC) for the HiMAT was estimated. A Friedman test was used to investigate the presence of a learning effect.
Currently, 9 patients were included. Six had a stroke, 1 a Guillain-Barré syndrome, 1 a spinal cord tumor treated by neurosurgery and 1 had an unknown peripheral disease affecting lower limbs. The HiMAT had no floor or ceiling effect. Internal consistency was excellent (α=. 975). Interrater and intrarater reliability of the HiMAT score was high (interrater ICC=. 99, intrarater ICC=. 99). The MDC was-2 to+4 points. No learning effect occurred (P=0, 845).
The French version of the HiMAT seems to be a reliable tool to measure high-level mobility in people with neurological conditions.
The Reunion experience has allowed the French Antilles to prepare for managing this epidemic by implementing an algorithm based on precise stripping algic and incapacitating phenomena. The role of the MPR in this dismemberment will allows distinguish true neurogenic damage to types of complex pain syndrome, combining autonomic neuropathy syndromes and tables of small fibers at the crossroads between diagnostic of arthropathy of periarthropaties, synovitis, tenosynovitis and tunnel syndrome on the rise during this epidemic period. And other complications such as bladder and sphincter disorders, and increase of spastic tables in patients suffering from chronic neurological disease. The reach of virus Zika shows an increased incidence of Guillain-Barre syndrome, brings interrogation with the appearance of atypical neurological damage such as myelitis, meningitis, cerebellites showing well this neurotropism. There are also atypical presentation on the neuro-urology plan that raises the question of the pathophysiology of such viruses. As has been the case for the Chikungunya, the overall vision of the MPR will allow better interpretation of pathological phenomena helping the understanding of the pathophysiology of these arboviruses. But it also plays a role in measuring the impact of emerging diseases on the autonomy of individuals.
Two patients with cerebral hemorrhagic stroke developed progressive flaccid quadriplegia and life-threatening dyspnea in acute stage. Combined with the cerebrospinal fluid and electromyogram results, they were diagnosed as having acute GBS. It was found that GBS and cerebral nervous system (CNS) hemorrhage can occur successively, but the different sequences of occurrence had completely different pathogeneses. GBS following CNS hemorrhage was found to be related to the imbalance of systemic inflammatory responses, whereas CNS hemorrhage following GBS was due to blood vessel autonomous dysfunction and the use of immunoglobulin intravenously. Both groups of patients had only good prognoses when they were intensively observed.
Despite being rare, GBS complicated with CNS hemorrhage deserves more attention due to its notable impact.
1 The PNS manifestations are Guillain Barre syndrome (GBS), autonomic disorder, mononeuropathy, polyneuropathy and plexopathy.1 Neuropathy in SLE can be clinically classified as mononeuritis multiplex and symmetrical and asymmetrical polyneuropathy. Symmetrical polyneuropathy being the most commonly seen clinical entity amongst the neuropathies in SLE. The neuropathy can be slowly progressive or acute in onset. Electrophysiologically, neuropathy is classified as axonal neuropathy, small fibre neuropathy, demyelinating neuropathy, mixed axonal-demyelinating sensorimotor polyneuropathy and plexopathy. Axonal neuropathy is further divided into sensory, sensorimotor and mononeuritis multiplex. Demyelinating neuropathy can be of two types: acute inflammatory demyelinating polyneuropathy (AIDP) and sensory demyelinating polyneuropathy. Anecdotal case reports also suggest that CIDP can occur as part of SLE neuropathy.2.