Late-Onset Guillain-Barré Syndrome and Right Facial Nerve Palsy after COVID-19 Infection

Abstract

Here, we present a case of late-onset Guillain-Barré syndrome (GBS) associated with COVID-19. A 70-year-old woman presented with ascending paralysis and right lower motor neuron facial weakness 2 months after COVID-19 infection. Test results for SARS-CoV-2 immunoglobulin were positive at the time of presentation. Lumbar puncture showed albuminocytological dissociation, and electrophysiology showed features of demyelination with secondary axon loss. In the published literature on GBS associated with COVID-19, almost all patients presented with neurological symptoms 1–4 weeks after the infection. GBS can be an early or late manifestation after COVID-19. Patients with signs of paraparesis and facial weakness after COVID-19 should be carefully evaluated for immune-mediated central and peripheral nervous system disorders.

Keywords

• acute inflammatory demyelinating polyradiculoneuropathy
• covid-19
• sars-cov-2
• intravenous immunoglobulin-g
• immune-mediated neuropathy
• gbs