Table 1 Summary of the cases presented with Guillain–Barré syndrome following COVID-19 vaccination
From: Guillain–Barré syndrome following different COVID-19 vaccines: a case series
Cases | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
|---|---|---|---|---|---|---|---|
Gender | Male | Male | Male | Male | Male | Male | Female |
Age | 39 years | 29 years | 59 years | 53 years | 55 years | 59 years | 29 years |
Past history | COVID-19 vaccination (2nd dose) | COVID-19 vaccination (2nd dose) | COVID-19 vaccination (2nd dose) | Ischemic heart disease, COVID-19 vaccination (2nd dose) | COVID-19 vaccination (2nd dose) | Diabetes mellitus, hypertension, ischemic heart disease COVID-19 vaccination (3rd dose) | Portal and splenic vein thrombosis two months after receiving COVID 19 vaccination (2nd dose) |
Type of vaccine | Pfizer | Janssen | AstraZeneca | AstraZeneca | Pfizer | Sinopharm | AstraZeneca |
Latency | 5 days | 20 days | 30 days | 14 days | 30 days | 30 days | 60 days |
Presentation | Bilateral upper eyelid partial ptosis, bilateral ULs and LLS tingling and numbness, bilateral LLs and ULs flaccid weakness (proximal more than distal), truncal weakness, areflexia, bilateral glove and stocking hypesthesia | Bilateral ULs and LLs tingling and numbness, bilateral LLs and ULs flaccid weakness (proximal more than distal), areflexia, stretch signs, left facial nerve weakness | Bilateral ULs and LLs tingling and numbness, bilateral LLs flaccid weakness (proximal more than distal), bilateral ULs weakness (distal more than proximal), areflexia, stretch signs | Bilateral ULs and LLs tingling and numbness, bilateral ULs and LLs flaccid weakness (proximal more than distal), truncal muscle weakness, areflexia and respiratory muscle weakness | Low back pain, bilateral LLs tingling and numbness, bilateral LLs flaccid weakness (proximal more than distal), areflexia | Tingling in both LLs then ULS and bilateral LLs and ULs flaccid weakness (proximal more than distal) then bilateral facial nerve weakness, areflexia | Bilateral LLs tingling and numbness followed by bilateral ULs tingling and numbness then developed bilateral ULs and LLs flaccid weakness more on left, areflexia and bilateral facial nerve weakness, |
NCV | Sensory and motor axonal neuropathy | Axonal polyneuropathy of both lower limbs, with proximal neurogenic affection, | bilateral axonal polyradiculoneuropathy of both lower limbs | bilateral axonal polyradiculoneuropathy of LLs | bilateral axonal polyradiculoneuropathy of LLs | NA | Mixed axonal and demyelinating polyradiculoneuropathy |
CSF | Protein 38 mg/dl, glucose 93 mg/dl, LDH 15 u/l, no cells | NA | NA | NA | Protein 40.4 mg/dl, glucose 122.1 mg/dl, LDH 18.6 u/l, no cells | Protein 112 mg/dl, glucose 70 mg/dl and no cells | NA |
Treatment | 8 plasmapheresis sessions | Daily intravenous methylprednisolone 1 g for 7 days and 9 plasmapheresis sessions | Daily I intravenous methylprednisolone 1 g for 7 days and 6 plasmapheresis sessions | Daily intravenous methylprednisolone 1 g for 7 days and 6 plasmapheresis sessions | Daily intravenous methylprednisolone 1 g for 7 days then 7 plasmapheresis sessions | 5 sessions of plasmapheresis | 7 plasmapheresis and arrested in the 7th session then regained, stopped sessions, and received 6 doses of methyl prednisolone with no improvement and discharged on prednisone 60 mg |
Guillain–Barré syndrome (GBS) Disability Score (pretreatment) | 4 | 4 | 4 | 5 | 4 | 4 | 4 |
Guillain–Barré syndrome Disability Score (post-treatment) | 0 | 1 | 1 | 4 | 0 | 1 | 4 |
Outcome | Complete improvement | Partial improvement | Complete improvement except residual numbness | Partial improvement | Complete improvement | Complete improvement as regard weakness but still has tingling sensation in both upper and lower limbs | Partial improvement with regard to upper limb weakness |