Guillain-Barre Syndrome Publications (7449)


Guillain-Barre Syndrome Publications

Iran J Neurol
Iran J Neurol 2014 Jul;13(3):138-143
Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Background: Incidence and predominant subtype of Guillain-Barre syndrome (GBS) differs geographically. Electrophysiology has an important role in early diagnosis and prediction of prognosis. This study is conducted to determine the frequent subtype of GBS in a large group of patients in Iran and compare nerve conduction studies in axonal and demyelinating forms of GBS. Read More

Methods: We retrospectively evaluated the medical records and electrodiagnostic study (EDS) of 121 GBS patients who were managed in our hospital during 11 years. After regarding the exclusion criteria, patients classified as three groups: acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), and acute motor sensory axonal neuropathy (AMSAN). The most frequent subtype and then electrophysiological characteristic based on the time of EDS and their cerebrospinal fluid (CSF) profile were assessed. Results: Among 70 patients finally included in the study, 67% were men. About 63%, 23%, and 14% had AIDP, AMAN, and AMSAN, respectively. AIDP patients represented a wider range of ages compared with other groups. Higher levels of CSF protein, abnormal late responses and sural sparing were more frequent in AIDP subtype. Five AMSAN patients also revealed sural sparing. Conduction block (CB) was observed in one AMAN patient. Prolonged F-wave latency was observed only in AIDP cases. CB and inexcitable sensory nerves were more frequent after 2 weeks, but reduced F-wave persistency was more prominent in the early phase. Conclusion: AIDP was the most frequent subtype. Although the electrophysiology and CSF are important diagnostic tools, classification should not be made based on a distinct finding.

Transplant. Proc.
Transplant Proc 2014 ;46(9):3104-7
Hepatobiliopancreatic Surgery and Liver Transplant Unit, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.

The immunosuppressive management of liver transplant recipients suffering early calcineurin inhibitor-induced neurotoxicity is a challenge in daily clinical practice. We have assessed the use of everolimus as the main immunosuppressant in patients presenting severe neurotoxicity in the early post-transplantation period. From October 1988 to October 2012, 10 patients in our center received everolimus because of severe neurotoxicity in the 1st 3 months after transplantation. Read More

We analyzed several variables associated with this treatment, including patient characteristics, time from liver transplantation to conversion to everolimus, immunosuppression regimens before and after conversion, treatment efficacy, adverse events, and discontinuation after conversion. Median follow-up after conversion to everolimus was 27 months (range, 1-63 mo). Neurotoxic events were: akinetic mutism in 4 patients, repeated convulsions in 3, cerebrovascular accident in 1, Guillain-Barré syndrome in 1, and disabling tremor in 1. Treatment with calcineurin inhibitors was discontinued in all patients. Post-conversion regimens consisted of everolimus plus mycophenolate mofetil (MMF) plus steroids in 7 patients, everolimus plus MMF in 1, everolimus plus steroids in 1, and everolimus alone in 1. Liver function was maintained for ≥1 month in all patients except 1, who presented a severe rejection that was treated with steroid bolus and Neoral cyclosporine. Neurologic function was fully recovered in 8 patients. In 1 patient with akinetic mutism and another with convulsions, tacrolimus was reintroduced at 2 months and 1 month, respectively, after resolution of the neurotoxic event. Everolimus is feasible and effective as the main immunosuppressant in patients suffering severe neurotoxicity during the 1st 3 months after transplantation. It allows neurologic function to be recovered while maintaining adequate liver function.

J. Peripher. Nerv. Syst.
J Peripher Nerv Syst 2014 Nov 24. Epub 2014 Nov 24.
Department of Neurology, Basel University Hospital, Basel, Switzerland.

Ultrasonography can be used to visualize peripheral nerve abnormalities in immune-mediated neuropathies. The objective of this study was to prove the role of ultrasonography in acute phase of Guillain-Barré syndrome (GBS). Systematic ultrasonic measurements of several peripheral nerves including the vagal nerve as well as the 6(th) cervical nerve root were performed in 18 patients with GBS at day 1-3 after symptom onset and compared to 21 healthy controls. Read More

Nerve conduction studies of corresponding nerves were undertaken. Consequently, significant differences between the groups were found in compound muscle action potential amplitudes, distal motor latency, F-wave latency and persistency. Ultrasonic cross-sectional areas showed significant enlargement in all nerves except of the ulnar nerve (upper arm) and the sural nerve compared to healthy controls, most prominent in proximal and middle median nerve (p < 0.01). The vagal nerve also showed enlargement compared to controls (p < 0.05), which was most pronounced in patients with autonomic dysfunction compared to patients without (p < 0.05). C6 root diameter showed a significant correlation to the amount of CSF-protein (Pearson correlation, p <0.05). Ultrasonography shows nerve enlargement in several peripheral nerves including vagal nerve and C6 root in acute phase of GBS and could be an additional diagnostic tool, e.g., in GBS of atypical onset and autonomic dysfunction.

Understanding of chronic sequelae development after Campylobacter infection is limited. The objective of the study was to determine via systematic review and meta-analysis the proportion of Campylobacter cases that develop chronic sequelae.
A systematic review of English language articles published prior to July 2011 located using Pubmed, Agricola, CabDirect, and Food Safety and Technology Abstracts. Read More

Observational studies reporting the number of Campylobacter cases that developed reactive arthritis (ReA), Reiter's syndrome (RS), haemolytic uraemic syndrome (HUS), irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) ,Guillain Barre syndrome (GBS) or Miller Fisher syndrome (MFS) were included. Data extraction through independent extraction of articles by four reviewers (two per article). Random effects meta-analysis was performed and heterogeneity was assessed using the I2 value. Meta-regression was used to explore the influence of study level variables on heterogeneity.
A total of 31 studies were identified; 20 reported on ReA, 2 reported on RS, 9 reported on IBS, 3 studies reported on IBD, 8 reported on GBS, 1 reported on MFS and 3 reported on HUS. The proportion of Campylobacter cases that developed ReA was 2.86% (95% CI 1.40% - 5.61%, I2 = 97.7%), irritable bowel syndrome was 4.01% (95% CI 1.41% - 10.88%, I2 = 99.2%). Guillain Barre syndrome was 0.07% (95% CI 0.03% - 0.15%, I2 = 72.7%).
A significant number of Campylobacter cases develop a chronic sequela. However, results should be interpreted with caution due to the high heterogeneity.

J Clin Neuromuscul Dis
J Clin Neuromuscul Dis 2014 Dec;16(2):74-8
*Department of Neuroscience/Rehabilitation, Neurophysiology Unit, Arcispedale Sant'Anna, University of Ferrara, Ferrara, Italy; and †Department of Morphology, Surgery and Experimental Medicine, Anaesthesia and Intensive Care Unit, Arcispedale Sant'Anna, University of Ferrara, Ferrara, Italy.
J. Peripher. Nerv. Syst.
J Peripher Nerv Syst 2014 Nov 21. Epub 2014 Nov 21.
Department of Clinical Neurosciences, Institute of Psychiatry, King's College London, UK.

The pathogenesis of Guillain-Barré syndrome (GBS) is considered to be, at least in part, mediated by autoantibodies directed against neuronal antigens. Antibodies to contactin-associated protein-like 2 (CASPR2), part of the voltage-gated potassium channel complex (VGKC-complex), are associated with neurological disease predominantly affecting the peripheral nervous system but are not known to be associated with GBS. We report 2 cases of ganglioside antibody-negative paediatric GBS associated with CASPR2 antibodies. Read More

Both patients made a full clinical recovery. The tissue distribution and function of CASPR2 make it a biologically plausible autoimmune target in GBS and its clincial relevance in GBS should be determined in further studies.

Rheumatology (Oxford)
Rheumatology (Oxford) 2014 Nov 17. Epub 2014 Nov 17.
Christie NHS Foundation Trust, Arthritis Research UK Epidemiology Unit, Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, University of Manchester and Kellgren Centre for Rheumatology, NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK. Christie NHS Foundation Trust, Arthritis Research UK Epidemiology Unit, Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, University of Manchester and Kellgren Centre for Rheumatology, NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
J. Peripher. Nerv. Syst.
J Peripher Nerv Syst 2014 Nov 18. Epub 2014 Nov 18.
Unité de Réanimation Neurologique, Neurologie 1, Pôle des Maladies du Système Nerveux, Groupe, Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris et Université Pierre et Marie Curie, Paris; Institut Hospitalo-Universitaire - A - Institut du Cerveau et de la Moelle, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris et Université Pierre et Marie Curie, Paris.

Thirty-percent of Guillain-Barré syndrome (GBS) patients require mechanical ventilation in ICU. Post-traumatic stress disorder (PTSD) is found in ICU survivors, and the traumatic aspects of intubation and mechanical ventilation have been previously reported as risk factors for PTSD after ICU. Our objective was to determine long-term PTSD or post-traumatic stress symptoms in GBS patients after prolonged mechanical ventilation in ICU. Read More

We assessed GBS patients who had mechanical ventilation for more than two months. PTSD was assessed using Horowitz Impact of Event Scale (IES), IESRevisited (IES-R) and the Post-traumatic CheckList Scale (PCLS); functional outcome using Rankin and Barthel scales; QoL using Nottingham Health Profile (NHP) and 36-Item Short Form Health Survey (SF-36) and depression using Hospital Anxiety and Depression Scale (HAD) and Beck questionnaire. Thirteen patients could be identified and analyzed. They had only mild disability. They were neither anxious nor depressed with an anxiety HAD at 5 [4-11.5], a depression HAD at 1 [0 - 3.5] and a Beck at 1 [0-5]. QoL was mildly decreased in our population with a NHP at 78.5 [12.8-178.8] and mild decreased SF-36. Compared to the French population, the SF-36 sub-categories were, however, not statistically different. 22% of our 13 patients had PTSD and post-traumatic stress symptoms with a Horowitz IES at 12 [2-29], and an IES-R at 16 [2-34.5]. Although severe GBS patients requiring prolonged mechanical ventilation had good functional recovery and no difference in QoL, they had a high incidence of post-traumatic stress symptoms.

PLoS One 2014 17;9(11):e110532. Epub 2014 Nov 17.
Department of Palliative Care, Policy and Rehabilitation, School of Medicine, King's College London, London, United Kingdom; Regional Rehabilitation Unit, Northwick Park Hospital, London, United Kingdom.

To describe functional outcomes, care needs and cost-efficiency of hospital rehabilitation for a UK cohort of inpatients with complex rehabilitation needs arising from inflammatory polyneuropathies.
186 patients consecutively admitted to specialist neurorehabilitation centres in England with Guillain-Barré Syndrome (n = 118 (63.4%)) or other inflammatory polyneuropathies, including chronic inflammatory demyelinating polyneuropathy (n = 15 (8. Read More

1%) or critical illness neuropathy (n = 32 (17.2%)).
Cohort analysis of data from the UK Rehabilitation Outcomes Collaborative national clinical dataset. Outcome measures include the UK Functional Assessment Measure, Northwick Park Dependency Score (NPDS) and Care Needs Assessment (NPCNA). Patients were analysed in three groups of dependency based on their admission NPDS score: 'low' (NPDS<10), 'medium' (NPDS 10-24) and 'high' (NPDS ≥25). Cost-efficiency was measured as the time taken to offset the cost of rehabilitation by savings in NPCNA-estimated costs of on-going care in the community.
The mean rehabilitation length of stay was 72.2 (sd = 66.6) days. Significant differences were seen between the diagnostic groups on admission, but all showed significant improvements between admission and discharge, in both motor and cognitive function (p<0.0001). Patients who were highly dependent on admission had the longest lengths of stay (mean 97.0 (SD 79.0) days), but also showed the greatest reduction in on-going care costs (£1049 per week (SD £994)), so that overall they were the most cost-efficient to treat.
Patients with polyneuropathies have both physical and cognitive disabilities that are amenable to change with rehabilitation, resulting in significant reduction in on-going care-costs, especially for highly dependent patients.

World J Gastrointest Pathophysiol
World J Gastrointest Pathophysiol 2014 Nov;5(4):400-4
Lourdes Álvarez-Arellano, Consejo Nacional de Ciencia y Tecnología, México.

The purpose of this paper is to review current information about the role of inflammation caused by Helicobacter pylori (H. pylori) infection in neurological diseases such as Parkinson's disease, Alzheimer's disease, Guillain-Barré syndrome, multiple sclerosis, and other inflammatory diseases including ischemic stroke. Infection with H. Read More

pylori usually persists throughout life, resulting in a chronic inflammatory response with local secretion of numerous inflammatory mediators including chemokines [interleukin (IL)-8, macrophage chemotactic protein (MCP)-1, growth-regulated oncogene (GRO)-α] and cytokines [IL-1β, tumor necrosis factor (TNF)-α, IL-6, IL-12, interferon (IFN)-γ], which can pass into the circulation and have a systemic effect. The persistence of detectable systemic and local concentrations of inflammatory mediators is likely to alter the outcome of neurological diseases. These proinflammatory factors can induce brain inflammation and the death of neurons and could eventually be associated to Parkinson's disease and also may be involved in the development of Alzheimer's disease. However, most neurological diseases are the result of a combination of multiple factors, but the systemic inflammatory response is a common component and determinant in the onset, evolution, and outcome of diseases. However, more studies are needed to allow understanding of the effects and mechanisms by which the inflammatory response generated by H. pylori infection affects neurological diseases.

Saudi Med J
Saudi Med J 2014 Nov;35(11):1419
Department of Pediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad, Iraq. E-mail.
Clin Rev Allergy Immunol
Clin Rev Allergy Immunol 2014 Dec;47(3):259-63
Department of Internal Medicine, Centro Hospitalar São João, 4200-319, Porto, Portugal,

Uncommon or orphan diseases are less frequently addressed in mainstream medical journals and, as a consequence, their understanding and clinical recognition may rely on case series or anecdotal data with limited guidelines and management directions. The study of selected underrepresented autoimmune and allergy conditions is the subject of the present issue of Clinical Reviews in Allergy and Immunology to provide peculiar perspectives on common and rare themes. First, allergy remains a major concern for physicians worldwide despite the limited developments over the past years, particularly for antigens such as mite or Alternaria alternata, and due to the increasing incidence of drug hypersensitivity. Read More

Second, the female predominance of autoimmune diseases such as systemic sclerosis is well recognized but enigmatic, and a unifying hypothesis remains elusive. Third, the management of conditions triggered by infectious agents as in Guillain-Barre syndrome or mixed cryoglobulinemia is challenging, and clinical guidelines are needed in the setting of infections and autoimmunity. Fourth, gamma-delta T cells represent major players in innate immunity and are the subject of extensive studies in autoimmune diseases to provide new therapeutic targets for disease prevention or modulation in the near future. Ultimately, we acknowledge the major developments in the broad fields of rheumatology and immunology and expect that microbiota definition, epigenetics studies, and microRNA analysis will provide new exciting avenues toward the understanding and treatment of chronic and acute inflammation.

Panminerva Med
Panminerva Med 2014 Nov 12. Epub 2014 Nov 12.
Section of Gastroenterology, Department of Medical and Pediatric Sciences, Institute of Internal Medicine "A. Francaviglia", University of Catania, "G. Rodolico" Hospital, Bldg. 4 -- I Floor, Room 17, Catania, Italy.

A mutual impact of gastrointestinal tract (GIT) and central nervous system (CNS) functions has been recognized since the mid--twentieth century. It is accepted that the so--called gut--brain axis provides a two--way homeostatic communication, through immunological, hormonal and neuronal signals. A dysfunction of this axis has been associated with the pathogenesis of some diseases both within and outside the GIT, that have shown an increase in incidence over the last decades. Read More

Studies comparing germ--free animals and animals exposed to pathogenic bacterial infections, probiotics or antibiotics suggest the participation of the microbiota in this communication and a role in host defense, regulation of immunity and autoimmune disease appearance. The GIT could represent a vulnerable area through which pathogens influence all aspects of physiology and even induce CNS neuro--inflammation. All those concepts may suggest the modulation of the gut microbiota as an achievable strategy for innovative therapies in complex disorders. Moving from this background, the present review discusses the relationship between intestinal microbiota and CNS and the effects in health and disease. We particularly look at how the commensal gut microbiota influences systemic immune response in some neurological disorders, highlighting its impact on pain and cognition in multiple sclerosis, Guillain--Barrè Syndrome, neurodevelopment and behavioral disorders and Alzheimer's disease. In this review we discuss recent studies showing that the potential microbiota--gut--brain dialogue is implicated in neurodegenerative diseases. Gaining a better understanding of the relationship between microbiota and CNS could provide an insight on the pathogenesis and therapeutic strategies of these disorders.

Dtsch. Med. Wochenschr.
Dtsch Med Wochenschr 2014 Nov 12;139(47):2386-9. Epub 2014 Nov 12.
Department of Neurology, University Hospital Centre of Rijeka, Rijeka, Croatia.
Korean J Pediatr
Korean J Pediatr 2014 Oct 31;57(10):457-60. Epub 2014 Oct 31.
Department of Pediatrics, Chosun University School of Medicine, Gwangju, Korea.

A flaccid tetraparesis in Bickerstaff's brainstem encephalitis (BBE) is presumed to be a sign of overlapping Guillain-Barré syndrome (GBS). In addition, BBE and Fisher syndrome, which are clinically similar and are both associated with the presence of the immunoglobulin G anti-GQ1b antibody, represent a specific autoimmune disease with a wide spectrum of symptoms that include ophthalmoplegia and ataxia. A 2-year-old boy presented with rapidly progressive ophthalmoplegia, ataxia, hyporeflexia, weakness of the lower extremities, and, subsequently, disturbance of consciousness. Read More

He experienced bronchitis with watery diarrhea and had laboratory evidence of recent infection with Epstein-Barr virus (EBV). He was diagnosed as having overlapping GBS and BBE associated with EBV and received treatment with a combination of immunoglobulin and methylprednisolone, as well as acyclovir, and had recovered completely after 3 months. In addition, he has not experienced any relapse over the past year. We suggest that combinations of symptoms and signs of central lesions (disturbance of consciousness) and peripheral lesions (ophthalmoplegia, facial weakness, limb weakness, and areflexia) are supportive of a diagnosis of overlapping GBS and BBE and can be helpful in achieving an early diagnosis, as well as for the administration of appropriate treatments.

Neurology 2014 Nov 5. Epub 2014 Nov 5.
From the Department of Neurology (T.H.P.D., E.K.V., C.G.F., I.S.J.M.), University Medical Centre Maastricht; Department of Neurology (S.I.v.N., P.A.v.D.), Erasmus Medical Centre Rotterdam, the Netherlands; Department of Neurology (K.C.G.), St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA; Department of Neurology (W.L.V.d.P., N.C.N., L.H.v.d.B.), Rudolf Magnus Institute of Neuroscience University Medical Centre Utrecht, the Netherlands; Department of Neurological Sciences (E.N.-O.), Milan University, Humanitas Clinical Institute, Rozzano, Milan, Italy; Department of Neurology (J.M.L.), Hôpital de la Salpêtrière, Paris, France; Department of Neurology (P.Y.K.V.d.B.), Catholique University of Louvain, Belgium; Department of Clinical Neurosciences (G.L.), 3rd Neurology Unit, Milan, Italy; Department of Neurology (V.B., H.K.), Toronto General Hospital, Canada; Department of Neurology (M.P.T.L.), Centre for Neuromuscular Disease, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK; Department of Neurology (J.P.), Centre de Référence des Maladies Neuromusculaires et de la SLA, Hôpital de La Timone, Marseille, France; Department of Neurology (A.J.v.d.K.), Academic Medical Centre, Amsterdam, the Netherlands; Department of Neurology (A.F.H.), London Health Science Center, London, Canada; Department of Neurology (D.R.C.), Johns Hopkins School of Medicine, Baltimore, MD; and Department of Neurology (I.S.J.M.), Spaarne Hospital, Hoofddorp, the Netherlands.

We performed responsiveness comparison between the patient-reported Inflammatory Rasch-built Overall Disability Scale (I-RODS) and the widely used clinician-reported Inflammatory Neuropathy Cause and Treatment-Overall Neuropathy Limitation Scale (INCAT-ONLS) in patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and immunoglobulin M-monoclonal gammopathy of undetermined significance related polyneuropathy (IgM-MGUSP).
One hundred thirty-seven patients (GBS: 55, CIDP: 59, IgM-MGUSP: 23) with a new diagnosis or clinical relapse assessed both scales. Patients with GBS/CIDP were examined at 0, 1, 3, 6, and 12 months; patients with IgM-MGUSP at 0, 3, and 12. Read More

We subjected all data to Rasch analyses, and calculated for each patient the magnitude of change on both scales using the minimal clinically important difference (MCID) related to the individual standard errors (SEs). A responder was defined as having an MCID-SE ≥1.96. Individual scores on both measures were correlated with the EuroQoL thermometer (heuristic responsiveness).
The I-RODS showed a significantly higher proportion of meaningful improvement compared with the INCAT-ONLS findings in GBS/CIDP. For IgM-MGUSP, the lack of responsiveness during the 1-year study did not allow a clear separation. Heuristic responsiveness was consistently higher with the I-RODS.
The I-RODS more often captures clinically meaningful changes over time, with a greater magnitude of change, compared with the INCAT-ONLS disability scale in patients with GBS and CIDP. The I-RODS offers promise for being a more sensitive measure and its use is therefore suggested in future trials involving patients with GBS and CIDP.

Gac Med Mex
Gac Med Mex 2014 Nov-Dec;150(6):540-51
Departamento de Epidemiología, Instituto Nacional de Neurología y Neurocirugía, México, D.F.

There is regulated study and mandatory reporting of epidemiological surveillance of diseases worldwide. However, it is difficult to observe the behavior of conditions especially over time, and especially when it comes to diseases that are addressed by their severity in tertiary care units.
Describe and analyze the behavior of the major communicable neurological diseases subject to epidemiological surveillance for a period of seven years in the main National Institution of Health that takes in neurological, neurosurgical and psychiatric disorders in Mexico. Read More

The main conditions that are handled and reported were acute inflammatory polyneuropathy (Guillain Barre Syndrome) and viral encephalitis, 19.7 and 18.5%, respectively. The condition showing a tendency to decrease was neurocysticercosis, and conditions most strongly associated with mortality were diseases associated to the human immunodeficiency virus and unspecified viral encephalitis. The conditions were more frequent especially in men in the age group 25 to 44 years old. It is necessary to stress the importance of timely reporting of diseases under epidemiological surveillance in Mexico, since knowledge of the behavior of action allows decisions at all levels of care.

Exp Ther Med
Exp Ther Med 2014 Dec 30;8(6):1713-1716. Epub 2014 Sep 30.
Department of Neurology, Tianjin Third Central Hospital, Tianjin 300170, P.R. China.

A 58-year-old female exhibited the onset of symmetrical sensory abnormalities of the face and extremities. The neurological examination revealed normal muscle strength with abated or absent tendon reflexes. The patient experienced symmetrical glove- and stocking-type pinprick sensations in the distal extremities and a loss of temperature sensation, but had normal proprioception and vibration senses and joint topesthesia. Read More

The lumbar puncture showed protein cell separation at the fifth week after the onset of symptoms. At the same time-point, the electrophysiological examination showed demyelination changes involving the trigeminal nerve and the somatic motor nerve. Needle electromyography revealed normal results. The clinical symptoms ceased progression at the fourth week after symptom onset, and began to improve from the sixth. This case was considered to be sensory Guillain-Barré syndrome, which was characterized by its cranial nerve involvement.

Pan Afr Med J
Pan Afr Med J 2014 9;18:35. Epub 2014 May 9.
Medical Intensive Care Unit, Ibn Rochd University Hospital, Casablanca, Morocco.

The aim of the study is to compare efficacy of IvIg versus PE in treatment of mechanically ventilation adults with GBS in intensive care unit.
It is a prospective, non randomized study, realized in a medical ICU from 2006 to 2010. We included all patients with GBS who required mechanical ventilation (MV). Read More

We defined two groups: group 1 (group treated by IvIg: 0.4 g/kg/day for 5 days) and group 2 (group treated by PE: 4 PE during 10-14 days). We collected demographic characteristics, clinical and therapeutic aspects and outcome.
The quantitative variables are expressed on mean ± standard derivation and compared by Student test. The statistic analysis has been based on SPSS for windows. P < 0.05 is considered as significant.
Forty-one patients (21 in group 1 and 20 in group 2) were enrolled. The mean age was 37.4 ± 9.2 years, with a masculine predominance (75.4%). Electromyogram in all patients found acute inflammatory demyelinating polyradiculoneuropathy in 80.5% of patients. The mean length of hospitalization was 45.3 ± 9.2 days. The length of hospitalization of the IvIg group is less long than PE group (p = 0.03). The weaning of the MV was more precocious in IvIg group than PE group (p = 0.01). Also, the beginning of motility recuperation was precocious at IvIg group than PE group (p = 0.04).
Our work reveals a meaningful difference for the MV weaning and precocious recovery in IvIg group compared to PE group.

Neurol. Res.
Neurol Res 2014 Nov 4:1743132814Y0000000455. Epub 2014 Nov 4.
Oncol Lett
Oncol Lett 2014 Dec 16;8(6):2695-2698. Epub 2014 Sep 16.
Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450002, P.R. China.

Guillain-Barré syndrome (GBS) is a rare complication of malignant lymphoma. The current study describes a case of GBS in a patient with peripheral T-cell lymphoma not otherwise specified (PTCL-NOS). A 47-year-old male was admitted to the First Affiliated Hospital of Zhengzhou University (Zhengzhou, China) with systemic multiple subcutaneous nodules and was diagnosed with stage IV high-grade PTCL-NOS (according to the Revised European American Lymphoma Classification). Read More

During chemotherapy, severe infection and progressive flaccid quadriparesis appeared, which eventually developed to respiratory muscles paralysis. The clinical course and neurological examination were consistent with GBS. Following mechanical ventilation and intravenous immunoglobulin administration, the neurological symptoms were in remission after one month. Three months later, the patient achieved complete remission without any treatment during this period. We hypothesized that immune reconstruction may have a significant role in this phenomenon.

Epidemiol. Infect.
Epidemiol Infect 2014 Oct 30:1-19. Epub 2014 Oct 30.
Laboratory for Foodborne Zoonoses,Public Health Agency of Canada,Guelph,Ontario,Canada.

SUMMARY The objective of this systematic review and meta-analysis was to estimate the proportion of cases of non-typhoidal salmonellosis (NTS) that develop chronic sequelae, and to investigate factors associated with heterogeneity. Articles published in English prior to July 2011 were identified by searching PubMed, Agricola, CabDirect, and Food Safety and Technology Abstracts. Observational studies reporting the number of NTS cases that developed reactive arthritis (ReA), Reiter's syndrome (RS), haemolytic uraemic syndrome (HUS), irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) or Guillain-Barré syndrome (GBS), Miller-Fisher syndrome (MFS) were included. Read More

Meta-analysis was performed using random effects and heterogeneity was assessed using the I 2 value. Meta-regression was used to explore the influence of study-level variables on heterogeneity. A total of 32 studies were identified; 25 reported on ReA, five reported on RS, seven reported on IBS, two reported on IBD, two reported on GBS, one reported on MFS, and two reported on HUS. There was insufficient data in the literature to calculate a pooled estimate for RS, HUS, IBD, GBS, or MFS. The pooled estimate of the proportion of cases of NTS that developed ReA and IBS had substantive heterogeneity, limiting the applicability of a single estimate. Thus, these estimates should be interpreted with caution and reasons for the high heterogeneity should be further explored.

Pract Neurol
Pract Neurol 2014 Oct 29. Epub 2014 Oct 29.
Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia Brain & Mind Research Institute, University of Sydney, Camperdown, New South Wales, Australia.
J Coll Physicians Surg Pak
J Coll Physicians Surg Pak 2014 Oct;24(10):778
Department of General OPD Ward, Combined Military Hospital, Peshawar.