Disclosures: Benjamin Shekhtman, MD: No financial relationships or conflicts of interest

Case Diagnosis: The patient’s diagnosis was Covid-19 with resulting Guillain-Barre Syndrome.

Case Description: 32-year-old female with past medical history significant for asthma and alcohol abuse who had initially presented to ED for diarrhea, abdominal pain, and bloating. 1 week later, numbness and tingling traveled to right foot. Started on antibiotics and discharged home. Patient returned with ascending weakness and numbness with continued GI symptoms. Patient was found to be positive for SARS-CoV-19. She was diagnosed with acute colitis. Patient was treated with IV antibiotics, but during her hospital stay her ascending weakness worsened. Patient underwent IVIG and was transferred to the Cleveland Clinic. IVIG given. Repeat labwork and MRI studies showed no further evidence of worsened neurologic changes. EMG however showed generalized large fiber sensorimotor polyneuropathy, axon loss in type, severe in degree electrically. Transferred to ICU and intubated. Received 5 cycles of plasmapheresis.Her workup ultimately found albuminocytologic dissociation on LP, which along with her EMG results were indicative of a diagnosis of GBS. On admission: bed mobility dependent/max assist, bathing dependent. On discharge: bed mobility min assist, bathing SBA. Total length of rehabilitation 6 weeks

Setting: Acute Inpatient Rehabilitation FacilityAssessment/

Results: Physiatrists must be aware of the possible neurological sequelae of Covid infection. Inpatient rehabilitation may provide benefits for patients presenting with these neurological symptoms.

Discussion: This case highlights a potential clinical correlation between CoV-19 and Guillain-Barre Syndrome. Potentially this connection may be due to a postinfectious immune-mediated inflammatory process. Persistent sequelae of Guillain Barre Syndrome include neuromuscular weakness, upper motor neuron signs including tone and spasticity, atrophy, and sensory neuropathy. Neurologic manifestations may continue to be persistent after discharge from the hospital and can often benefit from acute rehabilitation.

Conclusion: The objective of this clinical case report is to highlight a potential clinical correlation between CoV-19, Guillain-Barre Syndrome and the functional outcomes of rehabilitation.

Level of Evidence: Level V

« Back to AAPM&R Annual Assembly 2021

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/covid-19-and-guillain-barre-a-case-report-and-literature-review/