Guillain-Barré syndrome (GBS) typically occurs after gastroenteritis and respiratory tract infec-tion, but surgery has also been considered one of the triggers. Posterior reversible encepha-lopathy syndrome (PRES) is a rare complication of GBS. A normotensive female in her 70s pre-sented ascending paralysis and frontal-parieto-occipital subcortical lesions with intermittent hypertension after spinal surgery. Nerve conduction studies revealed demyelinating polyneu-ropathy. The patient’s brain lesions disappeared with amelioration of hypertension. She was diagnosed with the demyelinating form of GBS and PRES caused by intermittent hypertension. Intravenous immunoglobulin G (IVIG) improved her symptoms without exacerbation of the PRES. Surgery can be a trigger of GBS, and GBS can cause PRES by hypertension and present as central nervous lesions. It is important to treat hypertension before using IVIG when PRES is suspected as a complication of GBS, since the encephalopathy can be exacerbated by IVIG. There may be more undiagnosed cases of the coexistence of GBS and PRES after surgery be-cause surgery itself can also cause PRES. Proper control of blood pressure and confirmation of negative central nervous lesions are required to treat GBS patients with IVIG safely.
Guillain-Barré Syndrome and Posterior Reversible Encephalopathy Syndrome following Spinal Surgery
iA_2021_24
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