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(searched for: doi:10.1007/s00115-012-3479-8)
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Martin K.R. Svačina, Helmar C. Lehmann
Published: 8 September 2021
Neurologie up2date, Volume 04, pp 271-279; https://doi.org/10.1055/a-1163-6617

Abstract:
Das Guillain-Barré-Syndrom (GBS) stellt die häufigste akute Polyradikuloneuritis dar. Neben rasch progredienten Paresen und Sensibilitätsstörungen können eine respiratorische Insuffizienz und eine Affektion des autonomen Nervensystems auftreten. Eine frühe Diagnosestellung und Therapie sind essenziell, um Komplikationen abzuwenden. Dieser Artikel beschreibt Ursachen und die klinische Versorgung bei einem GBS. Publication Date: 08 September 2021 (online) © 2021. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
Mary Shannon Byers
Journal of Biomedical Research & Environmental Sciences, Volume 2, pp 685-689; https://doi.org/10.37871/jbres1297

Abstract:
Uillain-Barré Syndrome is a life-threatening, demyelinating, autoimmune condition in which the body’s immune system attacks the myelin of the peripheral nervous system. Guillain-Barré Syndrome is characterized by ascending motor weakness and acute flaccid paralysis. Demyelination results in nerve inflammation, numbness, tingling, muscle weakness, structural damage to the myelin sheath, and possible respiratory system complications. The annual incidence rate is 1.1 to 1.8 per 100,000 persons worldwide. Guillain-Barré Syndrome is thought to be triggered by an antecedent infection such as a viral, gastrointestinal, or bacterial infection, food poisoning, or reaction to a vaccine. Approximately 9-11% of cases result in severe disability or death. The acute phase can vary in length from a few days to several months, although over 90% of patients begin rehabilitation within four weeks. Patient care involves a team of neurologists, physiatrist, internist, nurses, physical, occupational, and speech therapists, social worker, psychologist and family physician. Elevated cerebrospinal fluid protein, symmetrical muscle weakness, the rate and order at which symptoms appear, and the absence or prolonged latency of reflexes are hallmarks for diagnosing Guillain-Barré Syndrome. A lumbar puncture to test for protein levels in the brain and spinal cord, and nerve conduction velocity test may aid in proper diagnosis, critical for optimizing treatment options and minimizing further progression. Although there is no cure, treatment may consist of plasmapheresis, typically performed four times during hospitalization, or intravenous immunoglobulin. Intravenous immunoglobulin combined with plasmapheresis should be avoided. Although glucocorticoids could repair damage to the blood-nerve barrier, oral corticosteroids could delay recovery.
Dan-Feng Xu, Bing Wu, Jin-Xin Wang, Jian Yu,
World Journal of Clinical Cases, Volume 9, pp 1096-1102; https://doi.org/10.12998/wjcc.v9.i5.1096

Abstract:
Guillain-Barré syndrome (GBS) is a rare disorder that typically presents with ascending weakness, pain, paraesthesias, and numbness, which mimic the findings in lumbar spinal stenosis. Here, we report a case of severe lumbar spinal stenosis combined with GBS. A 70-year-old man with a history of lumbar spinal stenosis presented to our emergency department with severe lower back pain and lower extremity numbness. Magnetic resonance imaging confirmed the diagnosis of severe lumbar spinal stenosis. However, his symptoms did not improve postoperatively and he developed dysphagia and upper extremity numbness. An electromyogram was performed. Based on his symptoms, physical examination, and electromyogram, he was diagnosed with GBS. After 5 d of intravenous immunoglobulin (0.4 g/kg/d for 5 d) therapy, he gained 4/5 of strength in his upper and lower extremities and denied paraesthesias. He had regained 5/5 of strength in his extremities when he was discharged and had no symptoms during follow-up. GBS should be considered in the differential diagnosis of spinal disorder, even though magnetic resonance imaging shows severe lumbar spinal stenosis. This case highlights the importance of a careful diagnosis when a patient has a history of a disease and comes to the hospital with the same or similar symptoms.
, Shani Dahan, Kassem Sharif, Nicola Luigi Bragazzi, Abdulla Watad, Howard Amital
Published: 1 May 2018
Autoimmunity Reviews, Volume 17, pp 440-448; https://doi.org/10.1016/j.autrev.2017.11.037

Abstract:
Autoimmune Syndrome Induced by Adjuvant (ASIA) is a definition aimed to describe the common etiological process at the root of five clinical entities sharing similar symptomatology: macrophagic myofasciitis syndrome (MMF), Gulf War Syndrome (GWS), sick building syndrome (SBS), siliconosis, and post vaccination autoimmune phenomena. ASIA illustrates the role of environmental immune stimulating agents, or adjuvants, in the instigation of complex autoimmune reactions among individuals bearing a genetic preponderance for autoimmunity. The value of ASIA lies first in the acknowledgment it provides for patients suffering from these as yet ill-defined medical conditions. Equally important is the spotlight it sheds for further research of these poorly understood conditions sharing a common pathogenesis. In this article we elaborate on the significance of ASIA, review the current evidence in support of the syndrome, and address recent reservations raised regarding its validity.
, B. C. Kieseier, H. C. Lehmann
Published: 8 July 2015
The publisher has not yet granted permission to display this abstract.
Yaron Zafrir, Sharon Baum, Nancy Agmon-Levin, Yehuda Shoenfeld
Published: 15 May 2015
The publisher has not yet granted permission to display this abstract.
, Helmar C. Lehmann, Bernd C. Kieseier
Published: 16 December 2014
The publisher has not yet granted permission to display this abstract.
Sabrina Hense, , Stefan H. Kreisel, Lydie Marcelon, , Maike Tahden,
Published: 16 December 2014
Neuroepidemiology, Volume 43, pp 244-252; https://doi.org/10.1159/000369344

Abstract:
Background: The Guillain-Barré syndrome (GBS) occurs after infections and as an adverse reaction to vaccines. No detailed information on incidence rates (IRs) in Germany is available. Methods: This retrospective cohort study estimated age- and sex-specific IRs of GBS in Germany in the years 2007-2009 based on electronic healthcare data from the German Pharmacoepidemiological Research Database (GePaRD). Two case definitions were applied. GBS cases had a main discharge diagnosis of GBS. GBS_PROCEDURE cases in addition had codes for relevant diagnostic procedures. Crude and standardized IRs (SIRs) with 95% confidence intervals were stratified by year, age group, sex, region and season. IR ratios (IRRs) for each stratification factor were calculated by multivariable Poisson regression. Results: Among 13,297,678 persons, 889 (693) incident GBS (GBS_PROCEDURE) cases were identified. Overall SIRs per 100,000 person years were 2.4 (2.2-2.5) for GBS and 1.8 (1.7-2.0) for GBS_PROCEDURE. (S)IRs increased with age, peaking in the age group 70-79 years (IR GBS: 5.5 (4.7-6.5)) and were higher in males than in females (e.g., IR GBS: IRR = 1.5 (1.3-1.7)) and in February-April, as compared to the rest of the year. No regional pattern was observed. Conclusion: (S)IRs of GBS in Germany differed by age, sex and season and were comparable to those found in other studies. Results might be used as a comparator in vaccine safety monitoring.
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