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Post-traumatic (and postsurgical) Guillain-Barré Syndrome: a rare, but treatable entity
  1. Helen Grote1,2,
  2. Nicholas Keyi Sim3,
  3. Simon Rinaldi4 and
  4. Christopher Carswell2
  1. 1Neurology Department, Imperial College Healthcare NHS Trust, London, UK
  2. 2Neurology Department, Chelsea and Westminster Healthcare NHS Trust, London, UK
  3. 3Neurology department, Leeds Teaching Hospitals NHS Trust, Leeds, Leeds, UK
  4. 4Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, Oxfordshire, UK
  1. Correspondence to Dr Helen Grote; helen.grote{at}nhs.net

Abstract

Guillain-Barré syndrome (GBS) is an acute, monophasic, polyradiculoneuropathy usually provoked by a preceding infection. The cardinal features are progressive weakness in the upper and lower limbs accompanied by loss of deep tendon reflexes. The diagnosis is made on the basis of the clinical history and examination findings, supported by typical cerebrospinal fluid and electrophysiology findings. Trauma and surgery are well understood but rare precipitants of GBS, which clinicians should be aware of, in order not to miss an opportunity to use immunomodulatory therapies. Furthermore, the presence of postsurgical or post-traumatic GBS should prompt careful assessment for underlying malignancy or autoimmune disease associated with an acute demyelinating polyradiculoneuropathy. Here, we present a case of post-traumatic GBS and discuss the potential mechanisms that might underlie this, as well as the investigations and treatment that should be considered.

  • neurology
  • clinical neurophysiology
  • peripheral nerve disease
  • orthopaedic and trauma surgery

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Footnotes

  • Twitter @helengrote

  • Contributors HG and NS drafted the manuscript. HG prepared all figures, and edited the final manuscript. CC conceptualised the manuscript and made significant revisions. SR undertook detailed antibody testing, and made significant revisions to the manuscript. All authors commented on the final version of the manuscript and approved it for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.