Increased rates of Guillain-Barré syndrome associated with Zika virus outbreak in the Salvador metropolitan area, Brazil.

In mid-2015, Salvador, Brazil, reported an outbreak of Guillain-Barré syndrome (GBS), coinciding with the introduction and spread of Zika virus (ZIKV). We found that GBS incidence during April-July 2015 among those ≥12 years of age was 5.6 cases/100,000 population/year and increased markedly with increasing age to 14.7 among those ≥60 years of age. We conducted interviews with 41 case-patients and 85 neighborhood controls and found no differences in demographics or exposures prior to GBS-symptom onset. A higher proportion of case-patients (83%) compared to controls (21%) reported an antecedent illness (OR 18.1, CI 6.9-47.5), most commonly characterized by rash, headache, fever, and myalgias, within a median of 8 days prior to GBS onset. Our investigation confirmed an outbreak of GBS, particularly in older adults, that was strongly associated with Zika-like illness and geo-temporally associated with ZIKV transmission, suggesting that ZIKV may result in severe neurologic complications.

Sellar emptiness on routine magnetic resonance imaging.

Magnetic resonance imaging (MRI) has provided a clear view of the sella turcica and the pituitary gland, even on "routine" procedures that invariably include the sagittal T1-weighted sequence. A pituitary gland that does not fully occupy the sella is a common observation, even in normal individuals. Terms such as "empty sella" and "partially empty sella" have become more commonly used, occasionally giving rise to some confusion regarding their clinical significance. In a prospective study of 50 "near-normal" patients, based exclusively on the midsagittal T1-weighted image, we have found a statistically significant increase in sellar emptiness with age, a phenomenon that is more prominent in women. The finding of an empty or partially empty sella on routine MRI of the brain is therefore usually of no clinical significance.