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Case report
Late onset of Guillain-Barré syndrome following SARS-CoV-2 infection: part of ‘long COVID-19 syndrome’?
  1. Mina M Raahimi1,
  2. Alice Kane2,
  3. Christopher EG Moore3 and
  4. Ahmad W Alareed3
  1. 1Critical Care, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
  2. 2Acute Medical Unit, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
  3. 3Neurophysiology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
  1. Correspondence to Dr Mina M Raahimi; mina.raahimi{at}nhs.net

Abstract

We describe a case of delayed onset, acute demyelinating neuropathy secondary to novel SARS-CoV-2 infection. A previously healthy 46-year-old man presented with bilateral leg pain and loss of sensation in his feet 53 days after having COVID-19 pneumonitis. He developed painful sensory symptoms followed by a rapidly progressive lower motor neuron weakness involving all limbs, face and respiratory muscles, needing ventilatory support. In keeping with a diagnosis of Guillain-Barré syndrome, cerebrospinal fluid examination showed albuminocytologic dissociation and nerve conduction studies supported the diagnosis of an acute inflammatory demyelinating polyradiculoneuropathy. The delayed neurological dysfunction seen in our patient following SARS-CoV-2 infection may indicate a novel mechanism of disease that is part of the emerging ‘long COVID-19 syndrome’.

  • infectious diseases
  • neurology
  • immunology
  • COVID-19

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2020-240178

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    Footnotes

    • Contributors MMR—first author wrote this case report in collaboration with AK (second). The timeline and most tables were edited, if not designed by MMR. CM helped to rewrite parts of the discussion and abstract. He also assisted AWA in the development of table 2 and modified the table of the Asbury Cornblath criteria. CM and AK ensured the text reads well. AWA wrote parts of the investigations and created table 2.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.