Guillain-Barre syndrome tingling associated with COVID-19

Doctors are paying close attention to trends that could be associated with COVID-19 as the list of coronavirus symptoms continues to grow.

While neurological experts say isolated tingling in the hands and feet is probably not a common symptom of the virus, it is a symptom of a rare disorder that may be associated with COVID-19 called Guillain-Barré syndrome.

Guillain-Barré syndrome (GBS) is a rare disorder where the immune system attacks the body’s nerves, according to the Mayo Clinic website. Weakness and tingling in the hands and feet, medically known as paresthesia, are usually its first symptoms.

An April study from Italy published in the peer-reviewed New England Journal of Medicine found five out of 1200 coronavirus patients developed GBS.

“After a person has an infection, there can be an immune system confusion where the immune system attacks the insolation, or myelin sheath, around the peripheral nerves,” said Dr. Robert Fox, staff neurologist at the Cleveland Clinic’s Mellen Center for Multiple Sclerosis.

While it does happen, Fox said it’s very rare for a COVID-19 patients to develop this disorder.

Dr. Anthony Geraci, director of Neuromuscular Medicine at Northwell Health in New York, says most coronavirus-related GBS cases occur in the middle to later part of the infection process, about two weeks after the onset of COVID-19 symptoms.

While the vast majority of his patients exhibited common COVID-19 and GBS symptoms concurrently, he said one or two had a tingling in their hands and feet with no other symptoms. Other patients experienced more nuanced symptoms like diminished reflexes, he said.

Fox said if tingling doesn’t progress to other symptoms after a day or two, it’s unlikely GBS. Even if it’s not GBS, it can still be related to COVID-19.

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Tingling in the hands and feet can be associated with another more acute condition: anxiety. Fox said many people who get anxious and have panic attacks will report having a tingling sensation in their hands, feet or around their mouth.

“Sometimes patients think when we say it’s from anxiousness, we don’t believe them,” Fox said. “We really do believe them. We think (the tingling) is real."

However, both Geraci and Fox say it’s difficult to pinpoint the cause of tingling as it is a common symptom of multiple conditions.

“The problem with tingling is that anything is possible,” Geraci said. “It can come from so many realms and domains of the nervous system.”

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Whether it's a serious condition like GBS or something more acute like anxiety, Fox urges patients not to self-diagnosis to avoid the hospital. Contact you doctor with any concerning symptoms, either virtually or in person.

“It’s important for patients to know that it’s not their jobs to figure it out, but for them to pay attention to their symptoms and share that with a provider,” he said.

Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT. 

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