Guillain-Barré Syndrome and Posterior Reversible Encephalopathy Syndrome Associated with COVID-19

Abstract

On late December 2019, an epidemic of cases with unexplained pneumonia was first detected in Wuhan, China. Subsequently, the etiological agent was attributed to a novel coronavirus SARS-CoV-2, also designated as COVID-19. The disease primarily affects the respiratory tract, but involvement of the cardiovascular system, neurological system, gastrointestinal system, and renal system had been reported. Here, we report the case of a 60-year-old female who presented with progressive ascending pattern weakness of both lower limbs associated with the symptoms of severe headache and blurring of vision, which progressed to such an extent that she could only perceive light. Two weeks prior to hospitalization, she had fever, sore throat, dry cough, and myalgia. Subsequently, she tested positive for COVID-19 by? reverse transcription-polymerase chain reaction and imaging, and electrodiagnostic study was performed which was suggestive of Guillain–Barré syndrome (GBS) and posterior reversible encephalopathy syndrome (PRES). She was treated with intravenous immunoglobulin and antihypertensive medications, which resulted in a dramatic improvement of her symptoms. There had been reported cases of GBS and PRES associated with COVID-19 separately. However, this may be the first case report of concurrent occurrence of both the syndromes in a patient with the novel disease.