Zhang Yiliu, Huang Chuxin, Lu Wei, Hu Qing
Department of Neurology, The Second Xiangya Hospital of Central South University, Changsha, China.
Front Surg. 2022 Aug 25;9:903334. doi: 10.3389/fsurg.2022.903334. eCollection 2022.
To analyze clinical associations between Guillain-Barré syndrome (GBS) and trauma.
We retrospectively reviewed the data of eight patients with post-traumatic GBS between July 2011 and December 2018 at the Second Xiangya Hospital, China, and analyzed the triggers, clinical manifestation, examination results, treatment, prognosis, and potential mechanism related to post-traumatic GBS.
The included patients had GBS preceded by no risk factors other than trauma. Their age ranged from 15 to 60 years (the median age was 52 years), and six patients were males. The potential traumatic triggers included spinal surgery ( = 2), high-intensity exercise ( = 2), traumatic brain injury ( = 1), excessive fatigue ( = 1), ischemic stroke ( = 1), and cardiopulmonary resuscitation ( = 1). The major manifestation was symmetrical limb weakness and/or numbness in all patients. The diagnosis of GBS was based on the results of electromyography, albumino-cytological dissociation, or antiganglioside antibody in cerebrospinal fluid, and other diseases were excluded. Immunotherapy improved symptoms, except in one patient who died.
Trauma is a probable risk factor for GBS that is very easily overlooked, thereby leading to misdiagnosis in clinical practice. We emphasize a new concept of post-traumatic GBS to promote doctors' awareness when they meet people with weakness and sensory deficits after trauma, which benefit early diagnosis, timely treatment, and reduced mortality rate of GBS.
分析吉兰-巴雷综合征（GBS）与创伤之间的临床关联。
我们回顾性分析了2011年7月至2018年12月在中国中南大学湘雅二医院的8例创伤后GBS患者的数据，并分析了与创伤后GBS相关的诱发因素、临床表现、检查结果、治疗、预后及潜在机制。
纳入的患者除创伤外无其他危险因素。他们的年龄在15至60岁之间（中位年龄为52岁），6例为男性。潜在的创伤诱发因素包括脊柱手术（2例）、高强度运动（2例）、创伤性脑损伤（1例）、过度疲劳（1例）、缺血性中风（1例）和心肺复苏（1例）。所有患者的主要表现为对称性肢体无力和/或麻木。GBS的诊断基于肌电图、蛋白细胞分离或脑脊液中抗神经节苷脂抗体的结果，并排除了其他疾病。免疫治疗改善了症状，但有1例患者死亡。
创伤是GBS的一个很容易被忽视的潜在危险因素，从而导致临床实践中的误诊。我们强调创伤后GBS这一新概念，以提高医生在遇到创伤后出现无力和感觉障碍患者时的意识，这有利于GBS的早期诊断、及时治疗及降低死亡率。
