1.A Rare Presentation of Plexiform Neurofibroma
Journal of Surgical Academia 2018;8(1):39-42
We report on a rare case of a child with persistent right upper lid eversion with conjunctival prolapse since birth that failed various attempts in repositioning the right superior fornix at other centre. He was found to have a right supero-temporal orbital mass above the prolapsed area. Computerized tomography (CT) scan of orbit confirmed a right lacrimal gland tumour with thinning of the right lesser wing of sphenoid. An excision biopsy of the tumour via anterior orbitotomy and eyelid reconstruction were performed. Histopathology report reviewed plexiform neurofibroma of the lacrimal gland. Further physical examination confirmed presence ofmultiple café-au-lait spots. He was diagnosed as Neurofibromatosis Type 1
2.Guillain-Barré syndrome associated with SARS-CoV-2 vaccination: how is it different? a systematic review and individual participant data meta-analysis
Yerasu Muralidhar REDDY ; Jagarlapudi MK MURTHY ; Syed OSMAN ; Shyam Kumar JAISWAL ; Abhinay Kumar GATTU ; Lalitha PIDAPARTHI ; Santosh Kumar BOORGU ; Roshan CHAVAN ; Bharadwaj RAMAKRISHNAN ; Sreekanth Reddy YEDUGURI
Clinical and Experimental Vaccine Research 2023;12(2):143-155
Purpose:
An association between Guillain-Barré syndrome (GBS) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination has been reported. We aimed to summarize the clinical features of GBS associated with SARS-CoV-2 vaccination and determine the contrasting features from coronavirus disease-19 (COVID-19) associated GBS and GBS following other causes.
Materials and Methods:
We performed PubMed search for articles published between 1 December 2020 and 27 January 2022 using search terms related to “SARS-CoV-2 vaccination” and “GBS”. Reference searching of the eligible studies was performed. Sociodemographic and vaccination data, clinical and laboratory features, and outcomes were extracted. We compared these findings with post-COVID-19 GBS and International GBS Outcome Study (IGOS) (GBS from other causes) cohorts.
Results:
We included 100 patients in the analysis. Mean age was 56.88 years, and 53% were males. Six-eight received non-replicating virus vector and 30 took messenger RNA (mRNA) vaccines. The median interval between the vaccination and the GBS onset was 11 days. Limb weakness, facial palsy, sensory symptoms, dysautonomia, and respiratory insufficiency were seen in 78.65%, 53.3%, 77.4%, 23.5%, and 25%, respectively. The commonest clinical and electrodiagnostic subtype were sensory-motor variant (68%) and acute inflammatory demyelinating polyneuropathy (61.4%), respectively. And 43.9% had poor outcome (GBS outcome score ≥3). Pain was common with virus vector than mRNA vaccine, and the latter had severe disease at presentation (Hughes grade ≥3). Sensory phenomenon and facial weakness were common in vaccination cohort than post-COVID-19 and IGOS.
Conclusion
There are distinct differences between GBS associated with SARS-CoV-2 vaccination and GBS due to other causes. Facial weakness and sensory symptoms were commonly seen in the former and outcomes poor.