Guillain-Barré syndrome associated with Japanese encephalitis virus infection in China

Viral Immunol. 2014 Oct;27(8):418-20. doi: 10.1089/vim.2014.0049. Epub 2014 Aug 20.


Abstract Guillain-Barré syndrome (GBS) is preceded by an infection in about two-thirds of patients. However, the infectious organism is often not identified. GBS secondary to Japanese encephalitis virus (JEV) infection has been reported only in India. Herein, we report a case of GBS preceded by JEV infection in China. A 23-year-old male had generalized weakness, numbness in the extremities, and bilateral facial nerve paralysis. One week prior, he had a high fever with headache, and several days later, he developed facial diplegia and sensory disturbances. Physical examination revealed facial diplegia and a weak gag reflex, quadriparesis more pronounced distally, generalized hyporeflexia, and no Babinski sign. JEV IgM and hepatitis B surface antibody (HbsAb) tests were positive. Other tests for hepatitis B infection were negative. Nerve electrophysiology suggested an acute demyelinating sensorimotor polyradiculoneuropathy. His cerebrospinal fluid was clear, the leukocyte count was 5 × 10(6)/L (normal range: 0-5 × 10(6)/L), protein 0.62 g/L (normal range: 0.15-0.45 g/L), and JEV IgM was weakly positive. He was diagnosed with GBS associated with a recent JEV infection. Intravenous (IV) immunoglobulins combined with IV methylprednisone was administered for 5 days, and at the 3-month follow-up, a complete neurological recovery was noted. GBS may be associated with JEV infection. GBS exhibits a good response to intravenous immunoglobulin or plasma exchange and has a good prognosis making prompt diagnosis important.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Viral / blood
  • China
  • Encephalitis Viruses, Japanese / immunology
  • Encephalitis, Japanese / complications*
  • Guillain-Barre Syndrome / diagnosis*
  • Guillain-Barre Syndrome / pathology*
  • Hepatitis B Surface Antigens / blood
  • Humans
  • Immunoglobulin M / blood
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / therapeutic use
  • Male
  • Methylprednisolone / therapeutic use
  • Treatment Outcome
  • Young Adult


  • Anti-Inflammatory Agents
  • Antibodies, Viral
  • Hepatitis B Surface Antigens
  • Immunoglobulin M
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Methylprednisolone