Acute Onset of Guillain-Barré Syndrome After Elective Spinal Surgery

Background Guillain-Barré syndrome (GBS) is an acute peripheral neuropathy caused by an autoimmune response against myelin of peripheral nerves. GBS has been reported after surgery, in general, and after spinal surgery, in particular. In most cases, GBS developed 1–3 weeks after surgery. Methods Rep...

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Bibliographic Details
Published in:World neurosurgery 2015-08, Vol.84 (2), p.376-379
Main Authors: Boghani, Zain, Livingston, Andrew D, Simpson, Ericka P, Holman, Paul J, Grossman, Robert G
Format: Article
Language:English
Subjects:
Acute inflammatory demyelinating polyradiculoneuropathy
Acute motor axonal neuropathy
Complications
Elective Surgical Procedures - adverse effects
Foraminotomy - adverse effects
Guillain-Barre Syndrome - diagnosis
Guillain-Barre Syndrome - etiology
Guillain-Barre Syndrome - therapy
Guillain-Barré syndrome
Humans
Laminectomy - adverse effects
Lumbar Vertebrae
Male
Middle Aged
Neurosurgery
Spinal Cord Compression - etiology
Spinal Cord Compression - surgery
Spinal Diseases - complications
Spinal Diseases - pathology
Spinal Diseases - surgery
Spinal surgery
Time Factors
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Summary:Background Guillain-Barré syndrome (GBS) is an acute peripheral neuropathy caused by an autoimmune response against myelin of peripheral nerves. GBS has been reported after surgery, in general, and after spinal surgery, in particular. In most cases, GBS developed 1–3 weeks after surgery. Methods Report of 2 cases of GBS after elective spine surgery that developed in the immediate postoperative period. Results Within 1 and 3 hours after surgery, respectively, both patients developed ascending loss of motor and sensory function. They were taken back urgently to the operating room for wound exploration to ensure that an epidural hematoma had not developed. Cerebrospinal fluid studies and electromyography/nerve conduction velocity were then rapidly obtained and were compatible with acute inflammatory demyelinating polyradiculoneuropathy. Therapy was initiated with administration of intravenous immunoglobulin and plasmapheresis. Both patients made substantial motor recovery during the course of 1–2 years but have residual sensory abnormalities. Conclusions GBS developing acutely after spinal surgery is a rare occurrence but should be considered in the differential diagnosis of neurological deterioration after surgery. Rapid diagnosis and treatment are essential for recovery of neurological function.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2015.03.036