Table 2.
Laboratory parameters, Imaging and clinical outcomes of four cases presenting with Covid-19 associated GBS.
| Case | Chest X ray | NCS findings | CSF | MRI spine | Treatment | Outcome |
|---|---|---|---|---|---|---|
| 1 | Normal | Pure motor axonal polyneuropathy | Protein: 54 mg% Glucose:114 mg% | Mild degenerative changes. | IVIG: 2 g/kg over 5 days | Good improvement (Able to walk independently at discharge) |
| Cells = 5 cells/cmm; all lymphocytes | No Cord changes | |||||
| No nerve root enhancement | ||||||
| 2 | Ill-defined inhomogeneous infiltrates involving predominantly the upper lobes | Severe demyelinating sensorimotor polyneuropathy affecting all 4 limbs with evidence of conduction block involving both ulnar nerves. | Protein: 74 mg% Glucose:110 mg% | Mild degenerative changes. | IVIG: 2 g/kg over 5 days with supportive treatment | Deteriorated over the course of treatment. |
| Cells = 0 cells/cmm. | No Cord changes | |||||
| No nerve root enhancement | Day 2 into IVIg therapy, power in all 4 limbs had reduced to grade 1/5 and patient developed severe respiratory distress requiring intubation and mechanical ventilation. | |||||
| His respiratory involvement due to Covid-19 also continued to worsen and the patient expired after | ||||||
| 7 days of hospital admission. | ||||||
| 3 | Normal | Axonal sensorimotor polyneuropathy affecting all 4 limbs | Protein: 84 mg% glucose: 94 mg% | Mild degenerative changes. | IVIG: 2 g/kg over 5 days | Good improvement (Able to walk independently at discharge) |
| Cells = 5 cells/cmm; all lymphocytes | No Cord changes | |||||
| No contrast enhancement | ||||||
| 4 | Bilateral lower and midzone infiltrates | Pure motor demyelinating polyneuropathy involving all 4 limb and bifacial demyelinating neuropathy. | Protein: 52 mg%; | Mild degenerative changes. | IVIG: 2 g/kg over 5 days | Good improvement (Able to walk independently at discharge) |
| Glucose: 54 mg% | ||||||
| Cells: <5 cells/cmm; all lymphocytes | No Cord changes |