Abstract Details

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus implicated in the COVID-19 pandemic is associated with a range of respiratory symptoms as well as a wide range of neurological manifestations including Guillain-Barre syndrome (GBS).

In this case series, we present six cases of GBS in the setting of SARS-CoV-2 infection seen at our institution.

CASE DESCRIPTION:

Case 1/2: 88 and 80 year old females who both presented with ascending weakness and sensory deficits and had diminished reflexes on examination. Both tested positive for SARS-CoV-2 infection prior to symptom onset. CSF and electrodiagnostic work up were only performed for the second case, which demonstrated albuminocytologic dissociation and severe acute polyradiculitis, respectively.

Case 3: 57 year old male who presented with left facial weakness and asymmetric hemibody weakness with diffusely reduced reflexes. He tested positive for COVID-19 infection after symptom onset.  CSF studies demonstrated albuminocytologic dissociation.

Case 4/5: 45 and 37 year old females who both presented with bilateral facial and lower extremity weakness and reduced reflexes. Following SARS-CoV-2 infection, CSF evaluation in both cases revealed albuminocytologic dissociation. Electrodiagnostic evaluation in the second case demonstrated acute demyelinating polyradiculopathy.

Case 6: 60 year old female who presented with right eye ptosis and right lower extremity weakness/numbness following upper respiratory symptoms. Tested positive for SARS-CoV-2 infection. CSF evaluation demonstrated albuminocytologic dissociation.

In all the presented cases, some degree of weakness was present. Four of the cases demonstrated cranial nerve involvement. In two of the six cases, MRI Brain imaging revealed subtle enhancement within the internal auditory canal. CSF studies were performed on five out of the six cases, which demonstrated albuminocytologic dissociation in all the cases. Electrodiagnostic evaluation was conducted on two cases and demonstrated severe polyradiculopathy in both cases.