ABSTRACT
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by transient constriction of cerebral arteries, leading to severe headache and potential complications. The association between RCVS and Guillain-Barre syndrome (GBS) is rare and poorly understood and warrants further investigation. METHODS: A detailed case of RCVS in a patient with GBS was presented, followed by a comprehensive literature review. PubMed, Embase, and Google Scholar were searched for relevant cases and studies. RESULTS: The case involved a 62-year-old woman with GBS who developed RCVS. The literature review identified three additional reported cases. RCVS in GBS primarily affected middle-aged women and presented with a variety of neurological symptoms. Neuroimaging showed reversible vasoconstriction in the cerebral arteries, along with other complications such as posterior reversible encephalopathy syndrome, subarachnoid hemorrhage, and infarcts. While the treatment for GBS consisted mainly of intravenous immunoglobulin, specific treatments for RCVS remain unclear. CONCLUSIONS: The coexistence of RCVS and GBS is a rare occurrence. RCVS in GBS may result from the disruption of cerebral vascular tone regulation, possibly influenced by GBS-related dysautonomia and consequent high blood pressure. Recognizing RCVS in GBS patients is critical for appropriate management.
Subject(s)
Cerebrovascular Disorders , Guillain-Barre Syndrome , Posterior Leukoencephalopathy Syndrome , Subarachnoid Hemorrhage , Vasospasm, Intracranial , Middle Aged , Humans , Female , Vasoconstriction/physiology , Guillain-Barre Syndrome/complications , Posterior Leukoencephalopathy Syndrome/diagnosis , Cerebrovascular Disorders/complications , Subarachnoid Hemorrhage/complications , Vasospasm, Intracranial/complications , Vasospasm, Intracranial/diagnostic imagingABSTRACT
PURPOSE: To compare the effect of autologous serum eye drops with different diluents in patients with dry eyes and persistent epithelial defects. METHODS: Patients of Sjögren's syndrome (Group I), non-Sjögren's syndrome (group II) with dry eye, and persistent epithelial defects (Group III) were included. The eyes of each group were randomly treated with one of the following autologous serum eye drops: 100% serum (AS(100)), 50% serum with normal saline (AS(50NS)); 50% serum with sodium hyaluronate (AS(50HA)); or 50% serum with ceftazidime (AS(50CEF)). The differences in dry eye symptoms, Schirmer test I, tear break-up time (TBUT), corneal staining, and speed in epithelial healing were studied. RESULTS: In Group I, AS(100) showed fewer symptoms than AS(50NS), AS(50HA) and AS(50CEF) (all p < 0.01). AS(100) showed significantly better effect than AS(50NS), AS(50HA) and AS(50CEF) in decreasing corneal staining at the time point of 12-week post-treatment (p = 0.041, p < 0.001 and p < 0.001, respectively). In Group II, AS(100) was more effective than AS(50CEF) in decreasing symptoms and decreasing corneal staining (all p < 0.05). There was no significant difference in symptom and corneal staining between AS(100) and AS(50NS). In Group III, AS(100) was the most effective in achieving quick epithelial closure. CONCLUSION: In the eyes with Sjögren syndrome and persistent epithelial defects, AS(100) was the most effective in decreasing symptoms, corneal epitheliopathy and promoting fast closure of wound. In the eyes with non-Sjögren syndrome, AS(100) and AS(50NS) have similar effects in decreasing symptoms and corneal epitheliopathy.