Guillain–Barre Syndrome in Postpartum Period: Rehabilitation Issues and Outcome – Three Case Reports

Abstract

We report three females who developed Guillain–Barre Syndrome in postpartum period (within 6 weeks of delivery) and were admitted in the Neurological Rehabilitation Department for rehabilitation after the initial diagnosis and treatment in the Department of Neurology. The first case, axonal variant (acute motor axonal neuropathy [AMAN]) had worst presentation at the time of admission, recovered well by the time of discharge. The second case, acute motor sensory axonal neuropathy variant and the third case, AMAN variant presented at the late postpartum period. Medical treatment was sought much later due to various reasons and both the patients had an incomplete recovery at discharge. Apart from their presentations, rehabilitation management is also discussed in some detail.

Guillain Barre’ Syndrome– A post-infectious sequele of COVID-19 in postnatal period & its treatment modality: A case report

“…Overall incidence of GBS worldwide was reported only to be 1.1-1.8/100,000 in a literature review of the epidemiology of GBS 13 , so in this case also it is very much unlikely that GBS occurred due to pregnancy. However an important aspect according to pathophysiology is to differentiate whether GBS following COVID-19 is a para-infectious response or a true post infectious immune mediated response 14,15 .…”

Guillain Barre Syndrome following delivery in a pregnant woman infected with SARS-CoV-2

“…GBS worsens in the postpartum period due to restoration of cellular immunity, with an increase in delayed type of hypersensitivity which was adaptively depressed during pregnancy [8]. Gupta et al reported 3 cases of GBS, one appeared immediately after cesarean section and other two occurred between the 5th and 6th week postpartum [9]. In a study which analyzed the records of 47 patients with pregnancy and GBS, one patient presented in first trimester, seven patients (14.89%) were in second trimester, 15 (31.2%) were in third trimester and remaining 24 (51%) were presented in postpartum especially within 2 weeks (sharma).…”

Guillain-Barré Syndrome During the Postpartum Period

“…The diagnosis and management of GBS in pregnancy and postpartum is similar to that in the general population [ 5 ]. In some cases, the management of this rare presentation requires a transfer to intensive care units for artificial ventilation [ 18 ]. To the best of our knowledge, only one case of GBS in a postpartum patient after cesarean section under spinal anesthesia has been described; however, there is no strong evidence supporting the association of neuraxial anesthesia and GBS [ 19 ].…”