Early Onset of Guillain–Barré Syndrome Following Lumbar Disc Herniation Surgery: An Unexpected Clinical Evolution

Abstract

Letter: Guillain–Barré syndrome (GBS), is a neurologic complication rarely reported following a spinal surgery procedure.1, 2, 3, 4, 5, 6 GBS is a potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. It is the most common cause of acute flaccid paralysis, with an annual global incidence of approximately 1–2 per 100,000 person-years.7 Although the clinical presentation of the disease is heterogeneous, patients typically present with weakness and sensory signs in the legs that progress to the arms and cranial muscles. Disease progression can be rapid in approximately 20% of patients with respiratory failure requiring mechanical ventilation.8 Also, cardiac arrhythmias and blood pressure instability can occur following the involvement of the autonomic nervous system.9 The mortality is estimated at 3%–10% for patients with GBS even with the best medical treatment.10 On the onset of the clinical manifestation, GBS reach a plateau phase that can last from days to weeks or months with 60%–80% of full recovery.