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A difficult case
Locked in from fulminant GBS after lumbar spine surgery
  1. Reece M Hass,
  2. Eelco F M Wijdicks
  1. Neurology, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Eelco F M Wijdicks, Neurology, Mayo Clinic, Rochester, Minnesota, USA; wijde{at}mayo.edu

Abstract

Guillain-Barré syndrome (GBS) describes a neurological syndrome characterised by acute, areflexic paralysis, often preceded by an immune stimulating event such as infection or surgery. Spinal surgery as an inciting event is very uncommon with few reported cases. When paraparesis develops in close proximity of surgery, surgical complications should be considered, but if an asymptomatic clinical interval precedes a progressive ascending weakness this association weakens and may support an immunological mechanism. GBS after lumbar surgery is wholly unexpected and thus there are significant challenges in recognising and making the diagnosis. We report a case of fulminant GBS that progressed to loss of all motor function following elective lumbar spine surgery.

  • GUILLAIN-BARRE SYNDROME

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

http://dx.doi.org/10.1136/pn-2023-003925

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as online supplemental information.

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    Footnotes

    • Contributors RMH drafted the article and obtained consent from the patient’s family. EFMW developed the original idea and edited the draft for content and accuracy.

    • 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.

    • Provenance and peer review Not commissioned; externally peer reviewed by Yusef Rajabally, Birmingham, UK.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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