Table 1.
Features of patients with Guillain Barré syndrome from México, July-November 2016.
| Clinical/laboratory data | Patient, Age range in years | ||||
|---|---|---|---|---|---|
| A, 35–39 | B, 25–29 | C, 35–39 | D, 75–79 | E, 60–65 | |
| State of residence | Guerrero | Michoacán | Estado de México | Guerrero | Guerrero |
| Initial viral symptoms | Fever, headache, myalgias, polyarthralgia, retroocular pain, conjunctivitis, diarrhea, nausea, vomiting, | Headache, fever | Rash, pruritus, abdominal pain, diarrhea | None | Diarrhea |
| Time from systemic symptoms to neurological symptoms onset days | 7 | 9 | 3 | 0 | 3 |
| Neurologic symptoms/ signs | Distal paresthesias, upper and lower limbs weakness, bifacial palsy, oculomotor nerve palsy, generalized areflexia. | Upper and lower limbs weakness, bifacial palsy, dysphagia, dysarthria, generalized areflexia and dysautonomia. | Asymmetric upper and lower limbs weakness, allodynia, generalized areflexia and hypotonia. | Upper and lower limbs weakness generalized areflexia, hypotonia, oculomotor nerve palsy and bifacial palsy. | Distal paresthesias, upper and lower limbs weakness, generalized areflexia and hypotonia. |
| Days in hospital | 6 | 34 | 6 | 52 | 10 |
| Co-morbidities | None | Cranial trauma history | None | Obesity and smoking | None |
| Complications | None | ICU admission tracheostomy and gastrostomy | None | Pneumonia, ICU admission, tracheostomy and gastrostomy | None |
| Time from initial symptoms to CFS analysis (Days) | 13 | 8 | 4 | 7 | 7 |
| CSF | |||||
| Cell count x 106 cells/mm3 Protein mg/dL | 1 89 | 0 38 | 2 41 | 30 116 | 0 35 |
| Glucose mg/dL | 53 | 81 | 84 | 87 | 107 |
| Positive PCR for ZIKV in/ Viral load, Threshold cycle Ct <39 is positive | Serum/ 36.18, CSF/ 31.08, urine/ 32.16, saliva/ 33.43 | Saliva/ 33.61 | Serum/ 35.52 | Serum/ 38.62, urine/ 36.14 | CSF/ 37.63, urine/ 38.11 |
| Time from initial neurological symptoms to electrophysiological study (Days) | 8 | 12 | 5 | 9 | 12 |
| Electrophysiological patterns | AIDP Normal motor and sensory amplitudes, distal latency,conduction velocities and F waves. | AMAN Normal motor and sensory amplitudes, distal latency, conduction velocities and F waves.† | AMSAN Marked reduction of motor and sensory amplitudes, normal conduction velocities with slight prolonged latencies. | AMSAN Marked reduction of motor and sensory amplitudes, normal conduction velocities with slight prolonged latencies. | AIDP Marked prolonged distal latencies, reduced motor amplitude and absence of sensory potentials amplitudes, F waves absences. Slight reduction of conduction velocities. |
| Brighton criteria | 2 | 2 | 2 | 1 | 2 |
| Treatment | None, spontaneous improvement in 6 days | Plasma exchange (5 sessions) | IVIG 2 gr/kg/ 5 days | IVIG 2 gr/kg/ 5 days | Plasma exchange (4 sessions) |
| Hughes scale initial/at follow-up | 2/1 | 5/1(9 months) | 4/2 (2 months) | 5/1 (8 months) | 4/4 (at discharge) |
†
Control electrophysiological study (8 months later) showed better median, cubital and tibial motors amplitudes.
AMAN, acute motor axonal neuropathy; AIDP, acute inflammatory demyelinating polyneuropathy; AMSAN, acute motor and sensory axonal neuropathy; ICU, intensive care unit.