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

• Published in: Internal Medicine Vol. 60; no. 21; pp. 3477 - 3480
• Main Authors: Kakumoto, Toshiyuki, Kobayashi, Satoshi, Yuuki, Hayato, Kainaga, Mitsuhiro, Shirota, Yuichiro, Hamada, Masashi, Maeda, Meiko Hashimoto, Kubota, Akatsuki, Kawai, Mizuho, Saito, Masaaki, Ishiura, Hiroyuki, Toda, Tatsushi
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01.11.2021; Japan Science and Technology Agency
• Subjects: Case Report; Case reports; Coronaviruses; COVID-19; Cranial nerves; Demyelination; Dysautonomia; Facial nerve; Guillain-Barre syndrome; Guillain-Barré syndrome; Inflammation; Internal medicine; Intravenous administration; Intubation; Magnetic resonance imaging; Nerve conduction; Patients; Polyneuropathy; Rehabilitation
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.7355-21

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.