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Zika virus infection and Guillain-Barré syndrome: a review focused on clinical and electrophysiological subtypes
  1. Antonino Uncini1,
  2. Nortina Shahrizaila2,
  3. Satoshi Kuwabara3
  1. 1Department of Neuroscience, Imaging and Clinical Sciences, University ‘G. d'Annunzio’ Chieti-Pescara, Chieti, Italy
  2. 2Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  3. 3Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
  1. Correspondence to Professor Antonino Uncini, Department of Neuroscience, Imaging and Clinical Sciences, University ‘G. d'Annunzio’, Via Luigi Polacchi, Chieti 66100, Italy; uncini{at}


In 2016, we have seen a rapid emergence of Zika virus-associated Guillain-Barré syndrome (GBS) since its first description in a French-Polynesian patient in 2014. Current evidence estimates the incidence of GBS at 24 cases per 100 000 persons infected by Zika virus. This will result in a sharp rise in the number of GBS cases worldwide with the anticipated global spread of Zika virus. A better understanding of the pathogenesis of Zika-associated GBS is crucial to prepare us for the current epidemic. In this review, we evaluate the existing literature on GBS in association with Zika and other flavivirus to better define its clinical subtypes and electrophysiological characteristics, demonstrating a demyelinating subtype of GBS in most cases. We also recommend measures that will help reduce the gaps in knowledge that currently exist.


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  • Contributors AU and SK contributed to the conception of the manuscript. NS and AU contributed to the literature review, initial drafts of the manuscript, analyses of the electrophysiological data and preparing the tables. All authors contributed to the final editing of the manuscript.

  • Competing interests None declared.

  • Ethics approval Ethics Committee of Universities of Chieti, Malaya, Chiba.

  • Provenance and peer review Commissioned; externally peer reviewed.

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