Surgery and Guillain-Barré Syndrome: A Single-Center Retrospective Study Focused on Clinical and Electrophysiological Subtypes

Abstract

Background

Surgery-related Guillain-Barré syndrome (GBS) is often underestimated and sometimes difficult to diagnose. This study aimed to elucidate the clinical features and electrophysiological subtypes of post-surgical GBS.

Methods

We retrospectively reviewed 17 patients who developed post-surgical GBS after a recent surgery between 2015 and 2019. Clinical characteristics, electrophysiological examinations, lumbar puncture results and prognosis were assessed. As controls, we selected 66 patients hospitalized with non-surgical GBS.

Results

The median duration from the surgery to the onset of GBS symptoms was 16.0 days. The main types of surgeries preceding GBS were orthopedic, gastrointestinal and neurosurgery. Symmetrical distal limbs weakness was present in all 17 post-surgical GBS patients. The incidence of respiratory failure, autonomic dysfunction and muscle atrophy in post-surgical GBS patients was significantly higher than that in non-surgical GBS patients. Hughes Functional Grading Scale (HFGS) scores were also higher in the post-surgical GBS group both at the time of peak disease and 6 months after discharge. Electrophysiological studies revealed significant motor amplitudes reduction with relative preserved nerve conduction velocities and distal latencies, suggesting axonal subtypes of GBS.

Conclusion

GBS should be considered in patients with rapidly progressive muscle weakness after surgery. Such patients often exhibit axonal subtypes of GBS with severe motor dysfunction, high risk of respiratory failure, and poor prognosis.

Journal

Journal ID (nlm-ta): Neuropsychiatr Dis Treat

Journal ID (iso-abbrev): Neuropsychiatr Dis Treat

Journal ID (publisher-id): NDT

Journal ID (pmc): neurodist

Title: Neuropsychiatric Disease and Treatment

Publisher: Dove

ISSN (Print): 1176-6328

ISSN (Electronic): 1178-2021

Publication date (Electronic): 15 April 2020

Publication date Collection: 2020

Volume: 16

Pages: 969-974

Affiliations

[1 ]Department of Neurology, The Affiliated Hospital of Xuzhou Medical University , Xuzhou, Jiangsu 221004, People’s Republic of China

Author notes

Correspondence: Lei Bao Department of Neurology, The Affiliated Hospital of Xuzhou Medical University , Xuzhou, Jiangsu221004, People’s Republic of China Tel/Fax [phone] Email [e-mail]

[*]

These authors contributed equally to this work

Article

Publisher ID: 241128

DOI: 10.2147/NDT.S241128

PMC ID: 7167305

Copyright statement: © 2020 Bao et al.

License:

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

Page count

Figures: 2, Tables: 3, References: 25, Pages: 6

Funding

This study was supported by the National Natural Science Foundation of China (NSFC) NO. 81771282 and The Natural Science Foundation of the Jiangsu Province (Grant No: BK20180991).

Categories

Subject: Original Research