Unusual presentation of Guillain-Barré syndrome following traumatic bone injuries: report of two cases

Autor(es): Al-Hashel Jasem Yousef,John John K,Vembu Periasamy


Resumo: To report two cases of Guillain-Barré syndrome (GBS) which occurred following traumatic bone injuries. Two patients presented with traumatic bone injuries. The first was a 47-year-old female who was admitted with fracture of both tibial bones sustained during a road traffic accident. One week after surgical fixation of the fracture, she developed areflexic weakness of all four limbs and respiratory muscle weakness. The nerve conduction study was consistent with GBS. She was administered intravenous immunoglobulins which was repeated after 2 weeks. She recovered gradually. The second patient was a 31-year-old male who was admitted with 4-days history of severe back pain which occurred when he lifted a heavy weight. He then developed ascending areflexic weakness of all four limbs and bifacial weakness. X-ray and magnetic resonance imaging of the lumbosacral spine revealed fracture of L1 and L2 vertebrae. Nerve conduction studies confirmed the diagnosis of GBS. He was given mechanical ventilatory support and was treated with intravenous immunoglobulins and later plasmapheresis. However, his condition gradually deteriorated as he developed aspiration pneumonia and sepsis with multi-organ failure and finally expired. These cases highlight the importance of considering GBS as a differential diagnosis when patients with traumatic bone injuries develop acute neuromuscular weakness. Early diagnosis and treatment may prevent morbidity and mortality.


Palavras-Chave: Guillain-Barré syndrome; Intravenous immunoglobulin; Critical illness polyneuropathy; Nerve conduction velocity


Imprenta: Medical Principles and Practice, v. 22, p. 597-599, 2013


Identificador do objeto digital: 10.1159/000348797


Descritores: Guillain-Barre Syndrome - Pathogenesis ; Guillain-Barre Syndrome - Public health


Data de publicação: 2013