Zika Virus and Guillain-Barre Syndrome: Is There Sufficient Evidence for Causality?

Frontiers in Neurology
A Arturo Leis, Dobrivoje S Stokic


Worldwide concern over Zika virus causing Guillain-Barre syndrome (GBS) soared after recent reports that Zika-related weakness was due to GBS. A global strategic response plan was initiated with recommendations for at-risk countries to prepare for GBS. This plan has major economic implications, as nations with limited resources struggle to implement costly immunotherapy. Since confirmation of causality is prerequisite to providing specific management recommendations, it is prudent to review data endorsing a GBS diagnosis. We searched PubMed for manuscripts reporting original clinical, laboratory, and electrodiagnostic data on Zika virus and GBS. Five papers met criteria; four case reports and one large case-control study (French Polynesia) that attributed 42 paralysis cases to a motor variant of GBS. Brighton criteria were reportedly used to diagnose GBS, but no differential diagnosis was presented, which violates criteria. GBS was characterized by early onset (median 6 days post-viral syndrome), rapid progression (median 6 days from onset to nadir), and atypical clinical features (52% lacked areflexia, 48% of facial palsies were unilateral). Electrodiagnostic evaluations fell short of guidelines endorsed by American Academy of...Continue Reading


Jul 26, 2000·Neurology·P D SchellingerS Schwab
Sep 18, 2001·Archives of Neurology·K C Gorson, A H Ropper
Sep 25, 2002·The New England Journal of Medicine·A Arturo LeisMichael Winkelmann
Sep 22, 2010·Brain : a Journal of Neurology·Norito KokubunN Yuki
Mar 31, 2012·Frontiers in Neurology·A Arturo Leis, Dobrivoje S Stokic
May 19, 2012·BMJ Case Reports·Ashfaq LarikYee Sien Ng
Oct 29, 2013·Brain : a Journal of Neurology·Christiaan FokkeBart C Jacobs
Mar 15, 2014·Euro Surveillance : Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin·E OehlerFrédéric Ghawché
Jun 10, 2014·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Didier MussoV-M Cao-Lormeau
Sep 23, 2014·Practical Neurology·Benjamin R Wakerley, N Yuki
Feb 19, 2016·MMWR. Morbidity and Mortality Weekly Report·Dana L ThomasBrenda Rivera-García
Mar 8, 2016·Lancet·Sylvie MécharlesAnnie Lannuzel
Mar 12, 2016·Euro Surveillance : Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin·Benoît RozéGBS Zika Working Group
Mar 19, 2016·Nature Reviews. Neurology·Hemi Malkki
Apr 7, 2016·Arquivos de neuro-psiquiatria·Lucas Masiêro AraujoOsvaldo Jm Nascimento
Apr 14, 2016·Neuroradiology·Cristina Asvolinsque Pantaleão FontesEdson Marchiori
Jun 9, 2016·JAMA Neurology·Carl A Gold, S Andrew Josephson
Jun 30, 2016·Lancet·Leonelo E Bautista, Ajay K Sethi
Jul 1, 2016·Brain : a Journal of Neurology·Abelardo Q C AraujoAlexandra P Q C Araujo


Feb 9, 2017·Clinica Chimica Acta; International Journal of Clinical Chemistry·Lin-Jie ZhangLi Yang
Apr 19, 2018·Expert Review of Anti-infective Therapy·Francisco Javier Carod-Artal
Jun 16, 2018·Bulletin of the World Health Organization·Michelle M HabyLudovic Reveiz
Mar 5, 2020·Molecular Biology Reports·Francesca RombiSharon Yeoh

Related Concepts

Case-Control Studies
Differential Diagnosis
Guillain-Barre Syndrome
Neurology Speciality
Zika virus (organism)

Trending Feeds


Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Systemic Juvenile Idiopathic Arthritis

Systemic juvenile idiopathic arthritis is a rare rheumatic disease that affects children. Symptoms include joint pain, but also fevers and skin rashes. Here is the latest on this disease.

Chromatin Regulation and Circadian Clocks

The circadian clock plays an important role in regulating transcriptional dynamics through changes in chromatin folding and remodelling. Discover the latest research on Chromatin Regulation and Circadian Clocks here.

Central Pontine Myelinolysis

Central Pontine Myelinolysis is a neurologic disorder caused most frequently by rapid correction of hyponatremia and is characterized by demyelination that affects the central portion of the base of the pons. Here is the latest research on this disease.

Myocardial Stunning

Myocardial stunning is a mechanical dysfunction that persists after reperfusion of previously ischemic tissue in the absence of irreversible damage including myocardial necrosis. Here is the latest research.

Pontocerebellar Hypoplasia

Pontocerebellar hypoplasias are a group of neurodegenerative autosomal recessive disorders with prenatal onset, atrophy or hypoplasia of the cerebellum, hypoplasia of the ventral pons, microcephaly, variable neocortical atrophy and severe mental and motor impairments. Here is the latest research on pontocerebellar hypoplasia.

Cell Atlas Along the Gut-Brain Axis

Profiling cells along the gut-brain axis at the single cell level will provide unique information for each cell type, a three-dimensional map of how cell types work together to form tissues, and insights into how changes in the map underlie health and disease of the GI system and its crosstalk with the brain. Disocver the latest research on single cell analysis of the gut-brain axis here.

Chronic Traumatic Encephalopathy

Chronic Traumatic Encephalopathy (CTE) is a progressive degenerative disease that occurs in individuals that suffer repetitive brain trauma. Discover the latest research on traumatic encephalopathy here.

Related Papers

Jean-Marie JouannicDominique Eyrolle-Guignot
The New England Journal of Medicine
Thais Dos SantosMarcos A Espinal
Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)
J Morata Alba, R Alpera Lacruz
The Annals of Otology, Rhinology, and Laryngology
© 2021 Meta ULC. All rights reserved