Sudden Peripheral Neuropathy – Beware

Radicular pain [sciatica in arms or legs], painful paresthesiae [ funny feelings], and  muscle pains of sudden onset could precede paralyzing Guillain–Barré syndrome by up to 2 weeks in 36% of cases. Preceding diarrhea illness (suggesting connected Campylobacter jejuni infection] occurred in 34% cases and preceding respiratory / influenza like illness in 37% cases.  Worth being careful to follow these cases closely.

Neurology. 2010 Sep 22. [Epub ahead of print]
Pain in Guillain-Barre syndrome. A long-term follow-up study.
Ruts L, Drenthen J, Jongen JL, Hop WC, Visser GH, Jacobs BC, van Doorn PA
abstract here

  • Guillain – Barre is an acute illness leading to ascending (feet up) paralysis that left untreated can lead to death.
  • Gastroenteritis with diarrhea or respiratory/influenza illness with cough can precede 2/3 of cases
  • Peripheral neuropathy with
    • neck or back pains radiating down arms or legs in 22%
    • paresthesias 30%
    • muscle pains 52%
  • Pain levels were often 2-4/10 pain level and occurred in :
    • low back 35%
    • Interscapular  – 28%
    • Extremities – 70%
    • Neck – 28%
    • Trunk 11%
  • Pains would persist into paralytic phase
  • Antiganglioside antibodies are sometimes positive
  • 1/2 develop cranial nerve involvement and 87% have sensory symptoms during illness.

Comment –  they say one sees what one knows – well, now you know…

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