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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2012 August;25(4):311-2
A delayed form of Guillain-Barré syndrome following spinal trauma
Leeds Teaching Hospitals, Leeds, UK
Guillain-Barré syndrome (GBS) is an acute demyelinating polyneuropathy causing rapidly ascending weakness and areflexia. Infections are usually a precipitating cause in most of documented GBS cases. GBS is rare following trauma to the spine or neurosurgical intervention and only few cases have been reported. This case reports a rare and delayed presentation of GBS following trauma. A 63 year old male was admitted to the neurosurgical high dependency unit (HDU) following a motorbike vehicle collision. The patient sustained complex fracture dislocations at T6/7 as confimed by CT scan. Surgical intervention included vertebrectomy and insertion of a cage with plating. Ten days post surgery new neurological symptoms manifested with bilateral upper limb weakness progressing to complete paralysis. Neurophysiological studies confirmed GBS. This case therefore suggests the hypothesis that GBS can present late following trauma with a window of 10 to 14 days. As a result, the late onset of progressive polyneuropathy following trauma or surgery should always prompt an underlying diagnosis of GBS.