5 research outputs found
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Clinical and Neurophysiological Evidence of Mononeuritis Multiplex During the COVID-19 Era
Infection with the novel coronavirus that causes coronavirus disease 2019 (COVID-19) results in a variety of clinical symptoms, including various neurological abnormalities. Peripheral nervous system symptoms, such as peripheral neuropathies, were often recorded in the medical literature, primarily as Guillain-Barré syndrome. Mononeuropathy multiplex is a multifocal axonal neuropathy commonly associated with vasculitis or connective tissue disease. Recent evidence about its associations with severe COVID-19 infection and intensive care unit hospitalization is being considered. A 58-year-old man with clinical and electrophysiological confirmation of mononeuropathy multiplex was reported during the peri-COVID-19 illness. He was treated with steroids and achieved a satisfactory response. Therefore, clinical and neurophysiological evaluation is recommended for any patient presenting with neurological manifestations following COVID-19 infection
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Emerging Axonal Variants of Guillain Barré Syndrome “ AMAN and AMSAN “ as a Part of COVID-19 Sequalae
Background: Guillain-Barré syndrome (GBS) is an immune-mediated peripheral nerve disease. Its frequency was noticed to have increased during the COVID-19 period. Based on electrophysiological studies, the most common type of this disease is the demyelinating type. However, axonal types have also been seen.
Methods: A large, analytical, cross-sectional study involving 2523 patients over a one-year period was conducted in Basrah, southern Iraq, to evaluate the neurophysiological changes for peripheral neuropathies following COVID-19 infection using nerve conduction studies and needle electromyography. The current study aims to evaluate the prevalence, clinical, and neurophysiological characteristics of patients with axonal variants of GBS.
Results and conclusions: The study found that the axonal variants of GBS represent about 10% of the total reported GBS in the governorate, and they are developed in about 1 in 1000 patients attending the neurology and neurophysiology clinics who had a history of COVID-19 infectio
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Neurographic Evidence of Inflammatory Polyneuropathies in Peri-COVID-19 Circumstances and Their Relationship With Acute Disease Severity and Inflammatory Storm
Recently, there has been increasing evidence among people infected with coronavirus disease 2019 (COVID-19) of being diagnosed with the typical acute post-infectious inflammatory polyneuroradiculopathy that was formerly known as Guillain-Barré syndrome (GBS), and it is not uncommon that some of them develop chronic inflammatory demyelinating polyneuroradiculopathy (CIDP). However, there is still a large debate and controversy about the link between COVID-19 and polyneuropathy. As a result, a multicentric retrospective cohort study was conducted in Basrah Governorate in the south of Iraq that included 2240 patients over a period of six months. Of those, 1344 patients had a history of COVID-19 in the previous year, and 1.14% of them developed inflammatory polyneuropathy, while only 0.29% (896 patients) of those with no history of COVID-19 had developed inflammatory polyneuropathy. This difference is highly significant, with a relative risk equal to six. The majority of the inflammatory polyneuropathy (44.4%) was diagnosed four to 12 weeks after the COVID-19 infection, with GBS being the most common type (72.2% of cases). Moreover, the nerve conduction velocity, the distal latency, and the amplitude of the most studied nerves were slower, more prolonged, and lower, respectively, among the COVID-19 groups compared with the non-COVID-19 group. Furthermore, there is an inverse correlation between the nerve conduction velocity in the majority of studied nerves and certain inflammatory biomarkers, such as serum ferritin, interleukin-6, and c-reactive protein. Although the occurrence of inflammatory polyneuropathy is more common among the less severe groups of COVID-19, if it occurs in the severe groups, it shows a more aggressive presentation