Table 1


Onset of neurological
Neurological signs and symptomsCSF findings*Antiganglioside
MRI resultsTreatment and outcomes
10 days after fever, cough, sore throat and anosmiaFlaccid paraplegia; global areflexia; lower limb paresthesia (day 2).
Muscle weakness rapidly evolved to a flaccid areflexic tetraparesis, facial diplegia and respiratory failure admitted to the ICU (day 3)
Day 2: protein level, 198 mg/dL; white cell count, 18/mm3; negative PCR assay for SARS-CoV-2Positive†:
Anti-GM1 (1:70)
Anti-GD1a (1:72)
Anti-GD1b (1:64)
Not testedReceived one cycle of IVIg; still partially respiratory supported. Significant clinical improvement: MRC superior limb 4/5 and 3/4 inferior limb (day 33)
  • *On CSF analysis, all the patients had a normal glucose level and IgG index and a polyclonal pattern on electrophoresis. The normal range for the protein level is <55 mg/dL.

  • †Antiganglioside antibody ELISA test (Bühlmann GanglioCombi) was used to test for antibodies to GM1, GQ1b, GD1a and GD1b. Normal value <50.

  • CSF, cerebrospinal fluid; ICU, intensive care unit; IVIg, intravenous immunoglobulin; MRC, Medical Research Council.