A rapid onset of Guillain–Barre syndrome following spinal anesthesia for knee arthroscopy: a case report

Abstract Background Guillain–Barré syndrome, a rare autoimmune polyneuropathy, typically follows infections and rarely surgical procedures. Post-surgical Guillain–Barré syndrome is an uncommon subset with significant clinical implications. Case presentation We report the case of a 76-year-old Middle...

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Main Authors: Amin Ahmed Kapadia, Lena Koshy, Usman Ali, Salil Gupta, Hammad Naqi Khan
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Medical Case Reports
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Online Access:https://doi.org/10.1186/s13256-025-05136-y
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author Amin Ahmed Kapadia
Lena Koshy
Usman Ali
Salil Gupta
Hammad Naqi Khan
author_facet Amin Ahmed Kapadia
Lena Koshy
Usman Ali
Salil Gupta
Hammad Naqi Khan
author_sort Amin Ahmed Kapadia
collection DOAJ
description Abstract Background Guillain–Barré syndrome, a rare autoimmune polyneuropathy, typically follows infections and rarely surgical procedures. Post-surgical Guillain–Barré syndrome is an uncommon subset with significant clinical implications. Case presentation We report the case of a 76-year-old Middle Eastern (Bahrainian) male who developed Guillain–Barré syndrome immediately after undergoing routine knee arthroscopy under spinal anesthesia. Shortly postoperatively the patient developed urinary incontinence, followed by progressive bilateral lower limb weakness and sensory deficits. Neurological symptoms rapidly deteriorated by day two and urgent neurological evaluation was taken. Initial and repeat spinal magnetic resonance imaging showed no structural abnormalities, and cerebrospinal fluid analysis lacked albuminocytological dissociation, complicating diagnosis. Electrodiagnostic studies confirmed Guillain–Barré syndrome with demyelinating patterns. Treatment with intravenous immunoglobulin was initiated promptly, resulting in remarkable recovery. By discharge, the patient had regained full motor and sensory function and achieved complete recovery at 6 months follow-up. Conclusion This case highlights the challenges of diagnosing early post-surgical Guillain–Barré syndrome, which can present atypically and without classical cerebrospinal fluid findings. However, early recognition, multidisciplinary collaboration, and timely intravenous immunoglobulin therapy facilitated a favorable outcome. This report highlights the challenges of diagnosing early post-surgical Guillain–Barré syndrome and demonstrates the potential for complete recovery with prompt intervention, emphasizing the need for awareness and timely management in similar cases.
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spelling doaj-art-27ec5ccae6d34a878f4e6faf11975a122025-08-20T04:03:01ZengBMCJournal of Medical Case Reports1752-19472025-07-011911510.1186/s13256-025-05136-yA rapid onset of Guillain–Barre syndrome following spinal anesthesia for knee arthroscopy: a case reportAmin Ahmed Kapadia0Lena Koshy1Usman Ali2Salil Gupta3Hammad Naqi Khan4Department of Anesthesia, Aga Khan University HospitalDepartment of Anesthesiology, King Hamad University HospitalDepartment of Surgery, Aga Khan University HospitalDepartment of Anesthesiology, King Hamad University HospitalDepartment of Anesthesiology, King Hamad University HospitalAbstract Background Guillain–Barré syndrome, a rare autoimmune polyneuropathy, typically follows infections and rarely surgical procedures. Post-surgical Guillain–Barré syndrome is an uncommon subset with significant clinical implications. Case presentation We report the case of a 76-year-old Middle Eastern (Bahrainian) male who developed Guillain–Barré syndrome immediately after undergoing routine knee arthroscopy under spinal anesthesia. Shortly postoperatively the patient developed urinary incontinence, followed by progressive bilateral lower limb weakness and sensory deficits. Neurological symptoms rapidly deteriorated by day two and urgent neurological evaluation was taken. Initial and repeat spinal magnetic resonance imaging showed no structural abnormalities, and cerebrospinal fluid analysis lacked albuminocytological dissociation, complicating diagnosis. Electrodiagnostic studies confirmed Guillain–Barré syndrome with demyelinating patterns. Treatment with intravenous immunoglobulin was initiated promptly, resulting in remarkable recovery. By discharge, the patient had regained full motor and sensory function and achieved complete recovery at 6 months follow-up. Conclusion This case highlights the challenges of diagnosing early post-surgical Guillain–Barré syndrome, which can present atypically and without classical cerebrospinal fluid findings. However, early recognition, multidisciplinary collaboration, and timely intravenous immunoglobulin therapy facilitated a favorable outcome. This report highlights the challenges of diagnosing early post-surgical Guillain–Barré syndrome and demonstrates the potential for complete recovery with prompt intervention, emphasizing the need for awareness and timely management in similar cases.https://doi.org/10.1186/s13256-025-05136-ySpinal anesthesiaGuillen Barre syndromePost-surgical GBSKnee arthroscopy
spellingShingle Amin Ahmed Kapadia
Lena Koshy
Usman Ali
Salil Gupta
Hammad Naqi Khan
A rapid onset of Guillain–Barre syndrome following spinal anesthesia for knee arthroscopy: a case report
Journal of Medical Case Reports
Spinal anesthesia
Guillen Barre syndrome
Post-surgical GBS
Knee arthroscopy
title A rapid onset of Guillain–Barre syndrome following spinal anesthesia for knee arthroscopy: a case report
title_full A rapid onset of Guillain–Barre syndrome following spinal anesthesia for knee arthroscopy: a case report
title_fullStr A rapid onset of Guillain–Barre syndrome following spinal anesthesia for knee arthroscopy: a case report
title_full_unstemmed A rapid onset of Guillain–Barre syndrome following spinal anesthesia for knee arthroscopy: a case report
title_short A rapid onset of Guillain–Barre syndrome following spinal anesthesia for knee arthroscopy: a case report
title_sort rapid onset of guillain barre syndrome following spinal anesthesia for knee arthroscopy a case report
topic Spinal anesthesia
Guillen Barre syndrome
Post-surgical GBS
Knee arthroscopy
url https://doi.org/10.1186/s13256-025-05136-y
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