Guillain-Barré Syndrome; a Neurological Disease during Convalescence Period

Coronavirus can attack the central and peripheral nervous systems in different ways and produce neurological manifestations. This study aimed to summarize the neurological manifestations and electrophysiological studies of COVID-19 patients during the recovery phase, suggesting Guillain-Barré syndrome.

This case report study was done in the Department of Physiology, College of Medicine at Al-Mustansiriya University, in cooperation with Al-Yarmouk Teaching Hospital in Baghdad. Patients during the convalescent period (1-3 months post-infection) of COVID-19 disease with neurological manifestations were included. Neurologists and neurosurgeons referred the patients for an electromyography and nerve conduction study to identify their illnesses.

Seven patients (4 females and 3 males) presented with clinical manifestations that highly suggested Guillain-Barré syndrome. The patients were presented with a rapidly progressive ascending weakness of both lower and upper limbs and diffuse, hypo-or-areflexia of the deep tendon reflexes. The sensory symptoms were distributed in both hands and feet, pain, paresthesia, and numbness. Electrophysiology studies confirmed five patients have acute inflammatory demyelinating polyradiculoneuropathy, one patient has acute motor axonal neuropathy, and one has acute motor and sensory axonal neuropathy subtypes.

Clinical manifestations of Guillain-Barré syndrome confirmed by electrophysiological studies are associated with COVID-19, which show similarity with GBS due to the post-viral infections with an autoimmune background. Therefore coronavirus infection is an etiological factor of Guillain-Barré syndrome.