Acute Onset of Guillain-Barré Syndrome After Elective Spinal Surgery

Boghani, Zain; Livingston, Andrew D.; Simpson, Ericka; Holman, Paul J.; Grossman, Robert G.

doi:10.1016/j.wneu.2015.03.036

Cited by 22 publications

(27 citation statements)

References 25 publications

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“…While there are a few reports of GBS after open spinal surgery [11-16], the current case report differs from the previously reported cases in numerous ways. First, we present a case of GBS following MIS TLIF, which has never been reported.…”

Section: Discussioncontrasting

confidence: 74%

“…It is hypothesized that it results from autoimmune antibodies and inflammatory cell cross-reactivity with epitomes located on peripheral nerves, leading to demyelination and axonal damage [9]. The incidence of post-surgical GBS is reported at a rate of 5%-9.5% although it has only been previously reported in a few cases following spinal surgery [11-16].…”

Section: Discussionmentioning

confidence: 99%

“…Post-surgical GBS has been reported following gastrointestinal surgery, cardiac surgery, thoracic surgery, and orthopedic surgery [10]. There are few reported cases following open spinal surgery [11-16]; however, to our knowledge, there is no reported case following minimally invasive spinal transforaminal interbody fusion (MIS TLIF). Here we present a unique case of GBS following MIS TLIF.…”

Section: Introductionmentioning

confidence: 99%

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Guillain-Barre Syndrome After Minimally Invasive Transforaminal Interbody Fusion: A Case Report

Abode-Iyamah

Bohnen

2019

Cureus

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Guillain-Barre syndrome (GBS) is an autoimmune disorder in which an individual’s immune system attacks the peripheral nerve myelin. Although rare, but serious, the syndrome typically starts with numbness, tingling, or weakness in the lower extremities and progresses in an ascending fashion. Severe weakness can transmit into paralysis and respiratory compromise. Although rare, GBS has been reported as a complication of multiple surgeries including orthopedic, cardiovascular, transplant, and general surgeries. To our knowledge, we here present the first case report of GBS after minimally invasive transforaminal interbody fusion. Furthermore, we highlight the importance of understanding the presenting symptoms and identifying proper examination findings, particularly in the setting of confounding factors, for prompt diagnosis, treatment, and reduction of morbidity.

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Section: Discussioncontrasting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Guillain-Barre Syndrome After Minimally Invasive Transforaminal Interbody Fusion: A Case Report

Abode-Iyamah

Bohnen

2019

Cureus

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“…GBS has a reported postoperative incidence of 4.1 cases per 100,000 patients for the general population of the United States and an incidence of 1 case per 2000 patients following spinal surgery [ 2 ]. In most cases, GBS develops 1–3 weeks following surgery [ 6 ]. The mechanism behind the increased risk of GBS following surgery has not yet been fully elucidated.…”

Section: Discussionmentioning

confidence: 99%

A Rare Axonal Variant of Guillain-Barré Syndrome following Elective Spinal Surgery

Dowling

Dowling²

2018

Case Reports in Orthopedics

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Acute motor and sensory axonal neuropathy (AMSAN) is a rare axonal variant of Guillain-Barré syndrome. AMSAN is considered the most severe form of GBS, known for its rapid onset of severe symptoms, and often leading to quadriparesis within 7 days of initial symptom onset. We present a case of a middle-aged Caucasian female who developed AMSAN 2 weeks following an elective spinal surgery. Although rare, GBS has been reported as a complication of surgery. GBS classically presents as ascending motor weakness starting in the lower extremities following a gastrointestinal or upper respiratory tract infection. This patient's GBS manifested slightly differently, with both sensory and motor symptoms of her thoracic region and lower extremities, with no preceding history indicative of infection. To the authors' knowledge, this is the first reported case of AMSAN following spinal surgery. Because of its risk of significant morbidity and mortality, as well as similar presentation to more common spinal postoperative complications, GBS should always be included in the differential diagnosis whenever motor or sensory weakness is observed after spinal surgery.

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“…Autonomic dysfunction, especially cardiovascular instability, is a frequent accompaniment and has been attributed to subsequent hemorrhagic stroke in GBS patients [10,11,13] . Conversely, head trauma [2][3][4] , neurosurgery [1,9] or other intracerebral hemorrhagic injury [6] also result in GBS. According to previous literature reports, GBS and cerebral hemorrhage could occur successively.…”

Section: Introductionmentioning

confidence: 99%

Guillain-Barré Syndrome and Cerebral Hemorrhage: Two Cases and Literature Review

Liu²,

Pan³

et al. 2016

Eur Neurol

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Aims: The study aimed to investigate the potential relationships between Guillain-Barré syndrome (GBS) and cerebral hemorrhage. Methods: Two patients diagnosed with hemorrhagic stroke and GBS were reported. More specifically, the sequential occurrence and the corresponding mechanisms of these 2 diseases were analyzed. Results: Two patients with cerebral hemorrhagic stroke developed progressive flaccid quadriplegia and life-threatening dyspnea in acute stage. Combined with the cerebrospinal fluid and electromyogram results, they were diagnosed as having acute GBS. It was found that GBS and cerebral nervous system (CNS) hemorrhage can occur successively, but the different sequences of occurrence had completely different pathogeneses. GBS following CNS hemorrhage was found to be related to the imbalance of systemic inflammatory responses, whereas CNS hemorrhage following GBS was due to blood vessel autonomous dysfunction and the use of immunoglobulin intravenously. Both groups of patients had only good prognoses when they were intensively observed. Conclusions: Despite being rare, GBS complicated with CNS hemorrhage deserves more attention due to its notable impact.

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Acute Onset of Guillain-Barré Syndrome After Elective Spinal Surgery

Cited by 22 publications

References 25 publications

Guillain-Barre Syndrome After Minimally Invasive Transforaminal Interbody Fusion: A Case Report

Guillain-Barre Syndrome After Minimally Invasive Transforaminal Interbody Fusion: A Case Report

A Rare Axonal Variant of Guillain-Barré Syndrome following Elective Spinal Surgery

Guillain-Barré Syndrome and Cerebral Hemorrhage: Two Cases and Literature Review

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