Case Report: Delayed Guillain-Barré syndrome following trauma: A case series and manage considerations

Abstract

AimTo analyze clinical associations between Guillain-Barré syndrome (GBS) and trauma.Material and MethodsWe retrospectively reviewed the data of eight patients with post-traumatic GBS between July 2011 and December 2018 at the Second Xiangya Hospital, China, and analyzed the triggers, clinical manifestation, examination results, treatment, prognosis, and potential mechanism related to post-traumatic GBS.ResultsThe included patients had GBS preceded by no risk factors other than trauma. Their age ranged from 15 to 60 years (the median age was 52 years), and six patients were males. The potential traumatic triggers included spinal surgery (n = 2), high-intensity exercise (n = 2), traumatic brain injury (n = 1), excessive fatigue (n = 1), ischemic stroke (n = 1), and cardiopulmonary resuscitation (n = 1). The major manifestation was symmetrical limb weakness and/or numbness in all patients. The diagnosis of GBS was based on the results of electromyography, albumino-cytological dissociation, or antiganglioside antibody in cerebrospinal fluid, and other diseases were excluded. Immunotherapy improved symptoms, except in one patient who died.ConclusionsTrauma is a probable risk factor for GBS that is very easily overlooked, thereby leading to misdiagnosis in clinical practice. We emphasize a new concept of post-traumatic GBS to promote doctors' awareness when they meet people with weakness and sensory deficits after trauma, which benefit early diagnosis, timely treatment, and reduced mortality rate of GBS.

Guillain-Barré Syndrome with Incomplete Oculomotor Nerve Palsy after Traumatic Brain Injury: Case Report and Literature Review

“…A subsequent study has reported that surgery and trauma were possible triggers of GBS and trauma patients with surgical treatment exhibited a higher risk of developing GBS than those without [ 3 ]. Some recent studies also presented similar results, indicating TBI may be a risk factor of GBS [ 4 , 5 , 6 ]. Here, we report a case of GBS with incomplete oculomotor nerve palsy after traumatic brain injury.…”

Guillain-Barré Syndrome Following Lung Adenocarcinoma Surgery: A Case Report and Literature Review

“…First, psychological stress resulting from surgery has been associated with complex neuroendocrine and immune interactions, particularly Toll-like receptor 4 (TLR4) and tissue necrosis factor (TNF) polymorphism. Second, inflammatory responses may cause BBB breakdown after different surgeries [15]. There is accumulating evidence that an altered expression of heat shock protein (HSP), especially 70-kDa HSP70, and release of various cytokines may play a role in the pathogenesis, leading to myelin sheath and axon damage [2].…”