Guillain-Barré Syndrome During First-Trimester Pregnancy in a Primigravida: Rehabilitation and Clinical Outcomes

Anindya D* and Jaya D

Department of Physical Medicine and Rehabilitation, St. John's National Institute of Medical Sciences, India

^*Correspondance to: Anindya Debnath 

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Abstract:

Background: In the context of pregnancy, Guillain-Barre Syndrome (GBS) emerges as a rare immune-mediated polyradiculoneuropathy. It is clinically characterized by muscle weakness, hyporeflexia, and dysesthesia. Notably, managing GBS, especially during the first trimester of pregnancy, poses a challenge due to the absence of specific guidelines. Objective: This abstract seeks to underscore the significance of rehabilitation in the context of pregnant individuals coping with GBS, with a particular emphasis on the early stages of pregnancy. The aim is to address the unique challenges and considerations inherent to GBS during this period. This report details a distinctive case of a nullipara in her early twenties who developed Guillain- Barré Syndrome, Acute Motor Sensory Axonal Neuropathy (AMSAN) variant with autonomic dysfunction during the initial trimester of her pregnancy. The case presented here delves into this rare occurrence of GBS in the first trimester, placing a specific spotlight on the rehabilitation aspect. Materials and Methods: The patient was treated with Intravenous Immunoglobulin (IVIG), intubated and later tracheostomized. Intensive medical management for autonomic instability with concurrent physical, occupational, speech and swallow therapy facilitated early recovery and functional independence. Her neurological recovery and functional outcomes were assessed using Functional Independence Measure (FIM), Barthel Index, Hughes Functional Grading Scale, and Overall Disability Sum Score (ODSS). Results: In our case, the primary treatment approach comprised Intravenous Immunoglobulin (IVIG) administration, coupled with ongoing maternal and fetal surveillance, as well as prompt rehabilitation, all of which contributed to substantial improvements. Early rehabilitation interventions significantly enhanced her functional outcomes, ultimately enabling her to give birth to a healthy full-term neonate via caesarean section. Discussion and Conclusion: In pregnant patients with Guillain-Barre Syndrome (GBS), the recommended treatment includes standard therapies like IVIG and plasmapheresis, complemented by supportive care. It's important to highlight that GBS, in and of itself, doesn't necessitate terminating pregnancy. Fetal outcomes don't appear to be directly linked to the severity of polyradiculopathy. This case highlights the crucial role of comprehensive rehabilitation can be the cornerstone of recovery, breathing new life and vitality into the patient's journey. This medical report is among the few ones highlighting the potential utilization of a comprehensive rehabilitation treatment for a woman experiencing substantial disability during the first trimester of pregnancy.

Keywords:

Intravenous immunoglobulins; IVIG; Polyradiculoneuropathy; Pregnancy; Guillain Barré syndrome; Rehabilitation

Cite the Article:

Anindya D, Jaya D. Guillain-Barré Syndrome During First-Trimester Pregnancy in a Primigravida: Rehabilitation and Clinical Outcomes. Ann Clin Case Rep. 2024; 9: 2564..