Title : Guillain barre syndrome in a post covid-19 patient in the Philippines: A case report
Abstract:
Introduction: Different neurologic manifestations have been observed during the Coronavirus disease (COVID-19) pandemic. However, only a handful cases of Guillain Barre syndrome (GBS) in a COVID-19 patient have been reported. No case has been reported in the Philippines. This report describes the first case of GBS in a post COVID-19 patient in the Philippines.
Case presentation: A COVID-19 confirmed 70-year-old male was admitted to a tertiary hospital in Baguio City, Philippines who presented with ascending paralysis manifesting primarily as lower extremity weakness. During his admission, the patient developed dysphagia to both solid and liquid foods and unable to vocalize. Medical Research Council muscular strength score of 2/5 on proximal and 3/5 on distal left upper extremity, 1/5 on proximal and 2/5 on distal right upper extremity, 2/5 on both proximal and distal left lower extremity and 1/5 on both proximal and distal right lower extremities have been reported. The cerebrospinal fluid analysis showed cyto-albuminologic dissociation and GBS was confirmed via nerve conduction and electromyogram test. The patient underwent tracheostomy and was managed with intravenous immunoglobulin (IVIG). His weakness gradually improved and was discharged after 72 days of hospitalization with clinical improvement.
Discussion: Only a few cases of COVID-19 with GBS have been reported. We speculate that polyneuropathies such as GBS could manifest in COVID-19 patients, but more studies are needed to explore the morbidity, mortality and neurologic outcomes of these kind of patients.
Keywords: COVID-19, Guillain Barre syndrome, Polyneuropathy
