Guillain-Barré syndrome following severe head trauma and spine surgery.
Guillain-Barré syndrome (GBS) is an acute-onset inflammatory polyradiculoneuropathy usually triggered by an infectious disease. In some cases, GBS can occur without any preceding infectious episode, like after vaccination, epidural anaesthesia or surgery. A 73 years old woman had head and spine trauma. Body-TDM showed bilateral temporal and right frontal haematomas and fracture of the first lumbar vertebrae. Sextant and kyphoplasty were performed. She presented 14 days after surgery tetraparesis, swallowing difficulties and bilateral facial palsy. Electromyography was consistent with demyelinating neuropathy. Cerebrospinal fluid examination found albumino-cytological dissociation. Viral and bacterial serology and antiganglioside antibodies were negative. She was treated with intravenous immunoglobulins. Four months after discharge she had fully recovered except left peripheral facial palsy. GBS can rarely be triggered by head trauma or spine surgery. Physician must keep in mind this diagnosis whenever their patients present acute-onset neurological worsening in such context.
Aix-Marseille université, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France. fabrice.battaglia@ap-hm.fr
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F
Battaglia
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Sevy
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E
Moyse
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PH
Roche
D000058:Accidental Falls; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D020275:Guillain-Barre Syndrome / Q000209:etiology* / Q000628:therapy; D016489:Head Injuries, Closed / Q000150:complications*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D058498:Kyphoplasty; D008159:Lumbar Vertebrae / Q000601:surgery*; D009104:Multiple Trauma; D009431:Neural Conduction; D010243:Paralysis / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy; D011930:Reaction Time; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*
D016756:Immunoglobulins, Intravenous