Cranial Nerve Involvement and Dysautonomia in Post-COVID-19 Guillain-Barré Syndrome

Toshiyuki Kakumoto; Satoshi Kobayashi; Hayato Yuuki; Mitsuhiro Kainaga; Yuichiro Shirota; Masashi Hamada; Meiko Hashimoto Maeda; Akatsuki Kubota; Mizuho Kawai; Masaaki Saito; Hiroyuki Ishiura; Tatsushi Toda

doi:10.2169/internalmedicine.7355-21

CASE REPORTS

Cranial Nerve Involvement and Dysautonomia in Post-COVID-19 Guillain-Barré Syndrome

Toshiyuki Kakumoto, Satoshi Kobayashi, Hayato Yuuki, Mitsuhiro Kainaga, Yuichiro Shirota, Masashi Hamada, Meiko Hashimoto Maeda, Akatsuki Kubota, Mizuho Kawai, Masaaki Saito, Hiroyuki Ishiura, Tatsushi Toda

Author information

Toshiyuki Kakumoto
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan
Satoshi Kobayashi
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan
Hayato Yuuki
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan
Mitsuhiro Kainaga
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan
Yuichiro Shirota
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan
Department of Clinical Laboratory, The University of Tokyo Hospital, Japan
Masashi Hamada
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan
Meiko Hashimoto Maeda
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan
Akatsuki Kubota
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan
Mizuho Kawai
Department of Neurology, Tokyo Kyosai Hospital, Japan
Masaaki Saito
Department of Neurology, Tokyo Kyosai Hospital, Japan
Hiroyuki Ishiura
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan
Tatsushi Toda
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan

Keywords: COVID-19, Guillain-Barré syndrome, dysautonomia

JOURNAL OPEN ACCESS

2021 Volume 60 Issue 21 Pages 3477-3480

DOI https://doi.org/10.2169/internalmedicine.7355-21

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Abstract

The clinical characteristics of Guillain-Barré syndrome (GBS) after coronavirus disease 2019 (COVID-19) remain unclear due to the small number of cases. We herein report a case of a Japanese patient with post-COVID-19 GBS who presented with facial and limb muscle weakness, sensory deficits, and autonomic dysfunction. Nerve conduction studies revealed demyelination. Head magnetic resonance imaging showed contrast enhancement in the bilateral facial nerves. Systemic management, including intubation, intravenous immunoglobulin therapy, and rehabilitation, improved the patient's condition. This was the first Japanese case of acute inflammatory demyelinating polyneuropathy after COVID-19 and was characterized by autonomic dysfunction and facial nerve enhancement.

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