Abstract Details

Title Guillain-Barre Syndrome preceded by SARS-CoV-2 Infection in Setting of L2-L4 Radiculopathy/Plexopathy

Topic General Neurology

Presentation(s) General Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 059

Objective Present a unique case of Guillain-Barre Syndrome after SARS-CoV-2 infection in the setting of multiple etiologies

Background There is currently a worldwide pandemic involving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), more commonly known as coronavirus disease 19 (COVID-19). Due to the novelty of this disease, there is still much unknown about it. It has been commonly shown to affect the respiratory system, but can also have neurological manifestations. Guillain-Barre Syndrome (GBS) is an acute immune-mediated polyneuropathy. It is often preceded by infection, and likely due to the immune-response cross-reacting with peripheral nerves.

Design/Methods NA

Results A 70 year-old-male presents with complaints of bilateral lower extremity (BLE) weakness and paresthesia. About two months prior, he was positive for COVID-19 requiring intubation. Neurological examination was significant for BLE weakness proximal>distal, areflexia throughout BLE. CSF analysis showed albuminocytologic dissociation. Patient had allergic reaction to IVIG. Plasmapheresis for 5 doses showed mild improvement. CT abdomen/pelvis showed bilateral iliac seromas and right hematoma. Electromyography (EMG) and nerve conduction studies (NCS) showed active denervation of bilateral muscles supplied by the L2-L4 suggesting a radiculopathy/plexopathy. Patient underwent drainage of right hematoma, but not left due to poor window. Patient was discharged to a rehabilitation facility and will follow-up outpatient.

Conclusions As COVID-19 is a novel disease, there is much to be learned about it. It has been shown to lead to GBS. Although a clinical picture of symmetrical symptoms, areflexia, and albuminocytologic dissociation on CSF can support the diagnosis, a multifactorial etiology can exist. Bilateral L2-L4 radiculopathy/plexopathy due to compression was contributing this patient’s symptoms. The development of bilateral compressive hematoma/seromas may have been related to COVID-19, as it can affect the complement cascade and coagulation system. It is important to keep a wide differential if treatment of GBS does not provide expected relief.

Authors/Disclosures
Gaurav Kathuria, MD PRESENTER	Dr. Kathuria has nothing to disclose.
Aakashi Shah, MD	Dr. Shah has nothing to disclose.
George C. Diaz, MD	Dr. Diaz has nothing to disclose.

��ɫ��

��ɫ��