Is Guillain–Barre syndrome following chickenpox a parainfectious disease? A case report and literature review

Autor: Bademain Jean Fabrice Ido, Sidi Mahamoud Guebre, Emeline Agathe Carama, Alfred Anselme Dabilgou, Christian Napon
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: BMC Neurology, Vol 23, Iss 1, Pp 1-5 (2023)
Druh dokumentu: article
ISSN: 1471-2377
DOI: 10.1186/s12883-023-03185-8
Popis: Abstract Background Polyradiculoneuropathy following infection with varicella zoster virus (VZV) is rare and most of the time, happens in the context of reactivation of latent VZV. We report a case of acute polyradiculoneuropathy following primary infection with VZV marked by atypical clinical features raising the hypothesis of a para-infectious disease. Case presentation We describe a 43-years-old male who developed ataxia, dysphagia, dysphonia, and oculomotor disorders (vertical binocular diplopia and bilateral ptosis) followed by quadriplegia with areflexia which occurred 4 days later. The patient had a history of varicella that occurred 10 days before the onset of these symptoms. Nerve conduction study revealed features consistent with an acute motor-sensory axonal neuropathy (AMSAN). Anti-ganglioside antibodies were negative. Based on clinical presentation and ancillary examination, we retain the Miller Fisher/Guillain-Barré overlap syndrome diagnosis. The patient was treated with high doses of methylprednisolone but the evolution of the disease was nevertheless marked by a complete recovery six weeks after onset of symptoms. Conclusion GBS following varicella is a rare but severe disease occurring most often in adults and marked by greater involvement of the cranial nerves. Its clinical features suggest that it is a para-infectious disease. Antiviral therapy has no effect on the course of the disease but its administration within the first 24 h after the onset of chickenpox in adults can prevent its occurrence.
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