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

Frontiers in Neurology
A Arturo Leis, Dobrivoje S Stokic

Abstract

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

References

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

Citations

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
Electrodiagnosis
Guillain-Barre Syndrome
Immunotherapy
Laboratory
Neurology Speciality
Unilateral
Evaluation
Zika virus (organism)

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