Postoperative delayed respiratory failure caused by Guillain-Barré syndrome--a case report.
Postoperative respiratory failure caused by Guillain-Barré syndrome (GBS) is a rare complication after general anesthesia. We report a GBS patient who after receiving an operation for polycystic liver disease under general anesthesia developed weakness of upper and lower extremities on the 3rd postoperative day, with decreased deep tendon reflex, which ultimately evolved into respiratory failure. Slurred speech and bilateral ptosis were also noted. All these manifested an acute peripheral polyneuropathy combined with bulbar involvement. According to the clinical picture, CSF examination and results of nerve conduction tests, Guillain-Barré syndrome was diagnosed. Plasmapheresis was immediately arranged and her motor weakness problem was soon improved after treatment. No neurological sequelae were found two months after discharge. Postoperative muscle weakness is usually caused by residual effects of anesthetic agents or surgical complications. But it may sometimes be related to some rare neurological diseases. To prompt an accurate diagnosis of Guillain-Barré syndrome is important because it can help forestall fatal complications. In addition, the prognosis will be encouraging with early treatment.
Kuok
Chi-Hang
CH
Department of Anesthesiology, Hsinchu Mackay Memorial Hospital, Hsinchu City, Taiwan, ROC. kch185@yam.com
Tsai
Pei-Shan
PS
Hsu
Yung-Wei
YW
Ko
Yuan-Pi
YP
Huang
Chun-Jen
CJ
Chen
Chien-Chuan
CC
D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications* / Q000628:therapy; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012131:Respiratory Insufficiency / Q000209:etiology*
D016756:Immunoglobulins, Intravenous