Download PDF
CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(04): 579-582
DOI: 10.1055/s-0044-1788063
Review Article

Traumatic Brain Injury and Guillain-Barré Syndrome: Tale of an Illicit Affair—Case Report and Brief Review of Literature

Viraat Harsh    *
1   Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
,
Hemant Alda   *
1   Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
,
Saurav K. Besra
1   Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
,
Ujjawal Roy
2   Department of Neurology, Roy Neuro Care, Bariatu, Ranchi, Jharkhand, India
,
Anil Kumar
1   Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Guillain-Barré syndrome (GBS) is a common entity in neurology clinics. A variety of etiologies have been implicated in the presentation of GBS. Although rarely reported, traumatic brain injury (TBI) has also been reported to cause GBS. In this article, we report a similar case of GBS that occurred following TBI and the patient presented with acute flaccid paraparesis with intact strength in upper limbs. Paraparesis progressed to quadriparesis simulating a case of spinal injury, without any correlating imaging findings. Nerve conduction study findings, cerebrospinal fluid studies, and clinical examination led to the diagnosis of post-TBI GBS. A review of similar cases reported in literature is also attached. High index of suspicion should be maintained for GBS in all cases of imaging-negative post-TBI limb weakness which may simulate acute spinal injury.

Keywords

Guillain-Barré syndrome - head injury - traumatic brain injury - spinal cord injury - paraplegia

* Co-first authors




Publication History

Article published online:
11 July 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Staff NP, Engelstad J, Klein CJ. et al. Post-surgical inflammatory neuropathy. Brain 2010; 133 (10) 2866-2880
    CrossrefPubMedSearch in Google Scholar
  • 2 Hadden RD, Cornblath DR, Hughes RA. et al; Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group. Electrophysiological classification of Guillain-Barré syndrome: clinical associations and outcome. Ann Neurol 1998; 44 (05) 780-788
    CrossrefPubMedSearch in Google Scholar
  • 3 Asbury AK, Cornblath DR. Assessment of current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol 1990; 27: S21-S24
    CrossrefPubMedSearch in Google Scholar
  • 4 Rantala H, Uhari M, Niemelä M. Occurrence, clinical manifestations, and prognosis of Guillain-Barré syndrome. Arch Dis Child 1991; 66 (06) 706-708 , discussion 708–709
    CrossrefPubMedSearch in Google Scholar
  • 5 Carr KR, Shah M, Garvin R, Shakir A, Jackson C. Post-Traumatic brain injury (TBI) presenting with Guillain-Barré syndrome and elevated anti-ganglioside antibodies: a case report and review of the literature. Int J Neurosci 2015; 125 (07) 486-492
    CrossrefPubMedSearch in Google Scholar
  • 6 Gensicke H, Datta AN, Dill P, Schindler C, Fischer D. Increased incidence of Guillain-Barré syndrome after surgery. Eur J Neurol 2012; 19 (09) 1239-1244
    CrossrefPubMedSearch in Google Scholar
  • 7 Sipilä JO, Soilu-Hänninen M. The incidence and triggers of adult-onset Guillain-Barré syndrome in southwestern Finland 2004-2013. Eur J Neurol 2015; 22 (02) 292-298
    CrossrefPubMedSearch in Google Scholar
  • 8 Duncan R, Kennedy PG. Guillain-Barré syndrome following acute head trauma. Postgrad Med J 1987; 63 (740) 479-480
    CrossrefPubMedSearch in Google Scholar
  • 9 De Freitas GR, De Freitas MR, Ferreira MC. Guillain-Barré syndrome and head trauma. Case report. Arq Neuropsiquiatr 1997; 55 (02) 315-318
    CrossrefPubMedSearch in Google Scholar
  • 10 Li X, Xiao J, Ding Y. et al. Clinical and electrophysiological features of post-traumatic Guillain-Barré syndrome. BMC Neurol 2017; 17 (01) 142
    CrossrefPubMedSearch in Google Scholar
  • 11 Hughes RA, Cornblath DR. Guillain-Barré syndrome. Lancet 2005; 366 (9497) 1653-1666
    CrossrefPubMedSearch in Google Scholar
  • 12 Illes Z, Blaabjerg M. Cerebrospinal fluid findings in Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathies. Handb Clin Neurol 2017; 146: 125-138
    CrossrefPubMedSearch in Google Scholar
  • 13 Huang SL, Qi HG, Liu JJ, Huang YJ, Xiang L. A rare complication of spine surgery: Guillain-Barré syndrome. World Neurosurg 2015; 84 (03) 697-701
    CrossrefPubMedSearch in Google Scholar
  • 14 Scozzafava J, Jickling G, Jhamandas JH, Jacka MJ. Guillain-Barré syndrome following thoracic spinal cord trauma. Can J Anaesth 2008; 55 (07) 441-446
    CrossrefPubMedSearch in Google Scholar
  • 15 Rattananan W, Thaisetthawatkul P, Dyck PJ. Postsurgical inflammatory neuropathy: a report of five cases. J Neurol Sci 2014; 337 (1-2): 137-140
    CrossrefPubMedSearch in Google Scholar
  • 16 Lin TM, Lee SS, Lin RT, Lai CS, Lin SD. Guillain-Barré syndrome following facial bone fracture. J Plast Reconstr Aesthet Surg 2006; 59 (05) 543-546
    CrossrefPubMedSearch in Google Scholar
  • 17 Rivas S, Douds GL, Ostdahl RH, Harbaugh KS. Fulminant Guillain-Barré syndrome after closed head injury: a potentially reversible cause of an ominous examination. Case report. J Neurosurg 2008; 108 (03) 595-600
    CrossrefPubMedSearch in Google Scholar
  • 18 Tan IL, Ng T, Vucic S. Severe Guillain-Barré syndrome following head trauma. J Clin Neurosci 2010; 17 (11) 1452-1454
    CrossrefPubMedSearch in Google Scholar
  • 19 Battaglia F, Sevy A, Moyse E, Roche PH. Guillain-Barré syndrome following severe head trauma and spine surgery. Rev Neurol (Paris) 2013; 169 (02) 166-168
    CrossrefPubMedSearch in Google Scholar
  • 20 Unal ZK, Umay EK, Tombak Y, Gundogdu I, Sultanoglu TE, Cakci FA. Guillain Barre syndrome following traumatic brain injury: a rare case. Middle East J Rehabil Health 2016; 3 (03) e38121
    Search in Google Scholar
  • 21 Jia H, Tian Y, Wu YM, Li B. Two cases of Guillain-Barré syndrome after cerebral hemorrhage or head trauma. Neuroimmunol Neuroinflamm 2017; 4: 61-64
    CrossrefSearch in Google Scholar