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Guillain-Barré, Zika Virus, and Morbidity

JAMA Neurology; ePub 2018 May 21; Dirlikov, et al

Guillain-Barré Syndrome (GBS) associated with Zika virus (ZIKV) infection was found to have higher morbidity during the acute phase and more frequent cranial neuropathy during acute neuropathy and 6 months afterward, a recent study found. During the ZIKV epidemic in Puerto Rico, prospective and retrospective strategies were used to identify patients with GBS who had neurologic illness onset in 2016. A total of 123 confirmed GBS cases were identified, of which 107 had specimens submitted for testing; there were 71 patients with and 36 patients without evidence of ZIKV infection. Follow-up telephone interviews with patients were conducted 6 months after neurologic illness onset; 60 patients with and 27 patients without evidence of ZIKV infection participated. Researchers found that the following clinical features were more frequent among patients with GBS and evidence of ZIKV infection compared with patients with GBS without evidence of ZIKV infection:

  • facial weakness (44 [62.0%] vs 10 [27.8%]),
  • dysphagia (38 [53.5%] vs 9 [25.0%]),
  • shortness of breath (33 [46.5%] vs 9 [25.0%]),
  • facial paresthesia (13 [18.3%] vs 1 [2.8%]), and
  • elevated levels of protein in cerebrospinal fluid (49 [94.2%] vs 23 [71.9%]).


Dirlikov E, Major CG, Medina NA, et al. Clinical features of Guillain-Barré Syndrome with vs without Zika virus infection, Puerto Rico, 2016. [Published online ahead of print May 21, 2018]. JAMA Neurology. doi:10.1001/jamaneurol.2018.1058.

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