Guillain-Barré syndrome following thoracic spinal cord trauma

Scozzafava, James; Jickling, Glen C.; Jhamandas, Jack H.; Jacka, Michael J.

doi:10.1007/bf03016311

Cited by 15 publications

(8 citation statements)

References 16 publications

(15 reference statements)

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“…The cases reported here highlight the importance of differentiating axonal GBS from critical illness polyneuropathy, which is a common cause of axonal polyneuropathy in trauma patients [ 19 ]. However, this can be difficult as axonal GBS can have striking similarities to critical illness polyneuropathy, in terms of clinical presentation and electrodiagnostic data.…”

Section: Discussionmentioning

confidence: 99%

“…Post-traumatic GBS is a rapidly progressive and severe neurologic complication that occurs after trauma [ 15 , 18 , 19 ]. Thus, when there is unexplainable progressive muscle weakness after trauma, GBS should be taken into consideration and corresponding measures should be taken to relieve the condition.…”

Section: Discussionmentioning

confidence: 99%

“…Reports of GBS in trauma patients is limited to case reports and no systematic research has been found so far discussing its immunological treatment. Therefore, an empiric course of intravenous immunoglobulin or plasma exchange might be valuable as it has been shown to improve prognosis [ 5 , 18 , 19 ]. Moreover, we found that some cases showed some clinical improvement, while others did not, when treated with intravenous methylprednisolone [ 15 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

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Clinical and electrophysiological features of post-traumatic Guillain-Barré syndrome

Xiao

Ding

et al. 2017

BMC Neurol

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BackgroundPost-traumatic Guillain-Barré syndrome (GBS) is a rarely described potentially life-threatening cause of weakness. We sought to elucidate the clinical features and electrophysiological patterns of post-traumatic GBS as an aid to diagnosis.MethodsWe retrospectively studied six patients diagnosed with post-traumatic GBS between 2014 and 2016 at Tianjin Medical University General Hospital, China. Clinical features, serum analysis, lumbar puncture results, electrophysiological examinations, and prognosis were assessed.ResultsAll six patients had different degrees of muscular atrophy at nadir and in two, respiratory muscles were involved. Five also had damaged cranial nerves and four of these had serum antibodies against gangliosides. The most common electrophysiological findings were relatively normal distal latency, prominent reduction of compound muscle action potential amplitude, and absence of F-waves, which are consistent with an axonal form of GBS.ConclusionsIt is often overlooked that GBS can be triggered by non-infectious factors such as trauma and its short-term prognosis is poor. Therefore, it is important to analyze the clinical and electrophysiological features of GBS after trauma. Here we have shown that electrophysiological evaluations are helpful for diagnosing post-traumatic GBS. Early diagnosis may support appropriate treatment to help prevent morbidity and improve prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical and electrophysiological features of post-traumatic Guillain-Barré syndrome

Xiao

Ding

et al. 2017

BMC Neurol

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“…The diagnosis of GBS was made because both cases had typical history, clinical features and satisfied the electrophysiological criteria [ 7 ]. Even though it is rare, cases of GBS have been reported following spinal, cranial, gastrointestinal, genitourinary, maxillofacial, orthopaedic, pulmonary, eye and cardiac surgeries [ 4 , 5 , 6 ]. Both patients in our report were suspected to have developed GBS following trauma and fracture of the bones.…”

Section: Discussionmentioning

confidence: 99%

“…It has also been reported in association with malignancies, cardiac surgery, renal transplant and spinal surgery [ 2 , 3 ]. GBS has rarely been reported to occur following post-traumatic bone injuries or after orthopaedic surgery [ 4 , 5 , 6 ]. We report 2 cases of GBS that occurred in the intensive care unit (ICU) in patients with either traumatic bone injuries or orthopaedic surgery.…”

Section: Introductionmentioning

confidence: 99%

Unusual Presentation of Guillain-Barré Syndrome following Traumatic Bone Injuries: Report of Two Cases

2013

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Objective: To report two cases of Guillain-Barré syndrome (GBS) which occurred following traumatic bone injuries. Presentation and Intervention: Two patients presented with traumatic bone injuries. The first was a 47-year-old female who was admitted with fracture of both tibial bones sustained during a road traffic accident. One week after surgical fixation of the fracture, she developed areflexic weakness of all four limbs and respiratory muscle weakness. The nerve conduction study was consistent with GBS. She was administered intravenous immunoglobulins which was repeated after 2 weeks. She recovered gradually. The second patient was a 31-year-old male who was admitted with 4-days history of severe back pain which occurred when he lifted a heavy weight. He then developed ascending areflexic weakness of all four limbs and bifacial weakness. X-ray and magnetic resonance imaging of the lumbosacral spine revealed fracture of L1 and L2 vertebrae. Nerve conduction studies confirmed the diagnosis of GBS. He was given mechanical ventilatory support and was treated with intravenous immunoglobulins and later plasmapheresis. However, his condition gradually deteriorated as he developed aspiration pneumonia and sepsis with multi-organ failure and finally expired. Conclusion: These cases highlight the importance of considering GBS as a differential diagnosis when patients with traumatic bone injuries develop acute neuromuscular weakness. Early diagnosis and treatment may prevent morbidity and mortality.

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