Clinical analysis on six cases of post-traumatic Guillain-Barré syndrome

Abstract

Objective To explore the clinical features of post?traumatic Guillain-Barré syndrome (GBS). Methods A retrospective analysis on clinical data of 6 cases was performed from August 2013 to June 2017 in our hospital, including clinical symptoms and signs, electrophysiological examinations, serum anti-ganglioside antibodies (AGA), cerebrospinal fluid (CSF), clinical diagnosis, treatment and prognosis. Results All cases had different histories of trauma or surgery, and the average duration from trauma to onset of GBS was 8 d. Clinical symptoms included progressive symmetrical weakness of limbs in 6 cases, respiratory muscle paralysis in 4 cases and cranial nerve damage in 4 cases. Serum anti-GM1 IgG antibodies were detected in one case, and anti-GM1 and GD1b IgG antibodies were detected in one case. CSF examination showed increased white blood cell (WBC) count in 2 cases, increased protein quantification in 6 cases, protein-cell separation in 4 cases, and the main electrophysiological findings were axonal injuries of motor fibers. Three cases were diagnosed as acute motor axonal neuropathy (AMAN), one case was acute motor-sensory axonal neuropathy (AMSAN), and 2 cases were acute inflammatory demyelinating polyradiculoneuropathy (AIDP). The average duration from onset to respiratory muscle paralysis was 3.25 d. One case abandoned treatment 27 d after mechanical ventilation and died. One case refused mechanical ventilation and died. Five cases were injected intravenous immunoglobulin (IVIg) for 0.40 g/(kg·d), and one case were only given glucocorticoid by intervenous drip for 500 mg/d. The average follow-up was 9.50 months. Four survival cases suffered from different degrees of muscle atrophy, 3 cases had good recovery and one had muscle grade 3-4. Conclusions Post-traumatic GBS can occur after different traumatic stress, with severe clinical manifestations, high mortality and poor prognosis. Timely electrophysiological examination helps to make an early diagnosis.

DOI: 10.3969/j.issn.1672-6731.2019.02.009