Physiotherapy Management of AIDP Guillain-Barré Syndrome Variant in a Tertiary Hospital in South-West Nigeria: A Case Report

Abstract

Guillain-Barré Syndrome (GBS) is an acute neurological condition marked by swift muscular weakening, with the most prevalent form being the Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) variety. This case report provides a comprehensive account of the physiotherapy treatment of a 35-year-old patient diagnosed with Acute Inflammatory Demyelinating Polyneuropathy (AIDP) in a tertiary hospital in South-West Nigeria. After contracting a gastrointestinal infection, the patient developed a gradual loss of strength in their limbs and paralysis of the facial muscles on both sides of the face. The diagnostic assessments verified Acute Inflammatory Demyelinating Polyneuropathy (AIDP), and the treatment consisted of intravenous immunoglobulin (IVIg), plasmapheresis, and a planned physiotherapy program. During a period of four weeks, the patient demonstrated notable enhancements in muscle strength, functional autonomy, and pain levels. This case emphasizes the significance of initiating physiotherapy early and maintaining a consistent approach. It also demonstrates the potential of customized rehabilitation programs to improve recovery in settings with limited resources. 

Keywords:

Guillain-Barré Syndrome, Acute Inflammatory Demyelinating Polyradiculoneuropathy, AIDP, physiotherapy management, immunomodulatory therapy

References

Katona I, Weis J. Diseases of the peripheral nerves. Handbook of clinical Neurology. 2018 Jan 1;145:453-74.

Bragazzi NL, Kolahi AA, Nejadghaderi SA, Lochner P, Brigo F, Naldi A, Lanteri P, Garbarino S, Sullman MJ, Dai H, Wu J. Global, regional, and national burden of Guillain–Barré syndrome and its underlying causes from 1990 to 2019. Journal of neuroinflammation. 2021 Dec;18:1-1.

Papri N, Islam Z, Leonhard SE, Mohammad QD, Endtz HP, Jacobs BC. Guillain–Barré syndrome in low-income and middle-income countries: challenges and prospects. Nature Reviews Neurology. 2021 May;17(5):285-96.

Leonhard SE, Mandarakas MR, Gondim FA, Bateman K, Ferreira ML, Cornblath DR, van Doorn PA, Dourado ME, Hughes RA, Islam B, Kusunoki S. Diagnosis and management of Guillain–Barré syndrome in ten steps. Nature Reviews Neurology. 2019 Nov;15(11):671-83.

Swathi S, Gayathri KC, Senthil P. Advanced Physiotherapy Intervention for Muscular Dystrophy. InPotential Therapeutic Strategies for Muscular Dystrophy 2023 Sep 23. IntechOpen.

Martinovičová M. Case Study of Physiotherapy Treatment of a Patient with Diagnosis Guillain-Barré syndrom.

Trivedi S, Mukherjee A. Clinical and Electrophysiological Pitfalls in the Diagnosis of Acute and Chronic Inflammatory Demyelinating Polyradiculoneuropathies. Pitfalls in the Diagnosis of Neurological Disorders. 2022 Oct 31:382.

Kondziella D, Waldemar G. Ancillary Investigations. InNeurology at the Bedside 2023 Nov 15 (pp. 283-311). Cham: Springer International Publishing.

Shang P, Feng J, Wu W, Zhang HL. Intensive care and treatment of severe Guillain–Barré syndrome. Frontiers in pharmacology. 2021 Apr 27;12:608130.

Ahmed I, Chakraborty SR, Mostofa Hussain MA, Rony MK. Patterns of Clinical Presentation and In-Hospital Outcome of Adult Patient with Guillain-Barre Syndrome. Glob Acad J Med Sci. 2024;6.

Mahwish N, Omara EIM, Rangraze IR, Qaeidy AA. Post-bariatric Guillain-Barré syndrome: a case report emphasizing timely recognition and intervention. Journal of Emergency and Critical Care Medicine [Internet]. 2024 Mar 30 [cited 2024 Jul 24];8(0). Available from: https://jeccm.amegroups.org/article/view/8449/html

Gawande I, Akhuj A, Samal S. Effectiveness of Physiotherapy Intervention in Guillain Barre Syndrome: A Case Report. Cureus [Internet]. 2024 Jan 10;16(1). Available from: https://assets.cureus.com/uploads/case_report/pdf/208014/20240111-3370-15vv09z.pdf

Kampylafka EI, Alexopoulos H, Dalakas MC, Tzioufas AG. Immunotherapies for neurological manifestations in the context of systemic autoimmunity. Neurotherapeutics. 2016 Jan 1;13(1):163-78.

Koike H, Chiba A, Katsuno M. Emerging Infection, Vaccination, and Guillain–Barré Syndrome: A Review. Neurology and Therapy. 2021 Jun 12;

Liu S, Zhang WW, Jia L, Zhang HL. Guillain–Barré syndrome: immunopathogenesis and therapeutic targets. Expert Opinion on Therapeutic Targets. 2024 Mar 3;28(3):131-43.

Pollock A, Baer G, Campbell P, Choo PL, Forster A, Morris J, et al. Physical rehabilitation approaches for the recovery of function and mobility following stroke. Cochrane Database of Systematic Reviews. 2014 Apr 22;4(4).

Summerton T. The effect of functional electrical stimulation of the abdominal muscles on motor performance and activity of the trunk in patients with stroke: A pilot study.