<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_jccm-2020-0008_s_006_w2aab2b8b1b1b7b1aab1c15b1Aa"><h3>Introduction</h3><p>There are rare reports of the occurrence of acute transverse myelitis and Guillain–Barré syndrome after various surgical procedures and general/epidural anaesthesia. The concomitant occurrence of these pathologies is very rare and is called Guillain–Barré and acute transverse myelitis overlap syndrome. In this article, we present the case of a second trimester pregnant patient who developed Guillain–Barré and acute transverse myelitis overlap syndrome.</p></sec><sec id="j_jccm-2020-0008_s_007_w2aab2b8b1b1b7b1aab1c15b2Aa"><h3>Case presentation</h3><p>We report the case of a 16-year-old female patient who underwent a therapeutic termination of pregnancy two weeks prior to the onset of the disease with gradual development of a motor deficit with walking and sensitivity disorders, fecal incontinence. The diagnosis was based on clinical exam, electroneurography and spinal magnetic resonance imaging. Endocrinopathies, infectious diseases, autoimmune and inflammatory diseases, neoplastic diseases and vitamin deficiencies were ruled out. Our patient attended five sessions of therapeutic plasma exchange, followed by steroid treatment, intravenous immunoglobulin with minimum recovery of the motor deficit in the upper limbs, but without significant evolution of the motor deficit in the lower limbs. The patient was discharged on maintenance corticotherapy and immunosuppressive treatment with azathioprine.</p></sec><sec id="j_jccm-2020-0008_s_008_w2aab2b8b1b1b7b1aab1c15b3Aa"><h3>Conclusions</h3><p>We report a very rare association between Guillain–Barré syndrome and acute transverse myelitis triggered by a surgical intervention with general anaesthesia. The overlap of Guillain–Barré syndrome and acute transverse myelitis makes the prognosis for recovery worse, and further studies are needed to establish the first-line therapy in these cases.</p></sec></abstract>

IntroductionThere are rare reports of the occurrence of acute transverse myelitis and Guillain–Barré syndrome after various surgical procedures and general/epidural anaesthesia. The concomitant occurrence of these pathologies is very rare and is called Guillain–Barré and acute transverse myelitis overlap syndrome. In this article, we present the case of a second trimester pregnant patient who developed Guillain–Barré and acute transverse myelitis overlap syndrome.Case presentationWe report the case of a 16-year-old female patient who underwent a therapeutic termination of pregnancy two weeks prior to the onset of the disease with gradual development of a motor deficit with walking and sensitivity disorders, fecal incontinence. The diagnosis was based on clinical exam, electroneurography and spinal magnetic resonance imaging. Endocrinopathies, infectious diseases, autoimmune and inflammatory diseases, neoplastic diseases and vitamin deficiencies were ruled out. Our patient attended five sessions of therapeutic plasma exchange, followed by steroid treatment, intravenous immunoglobulin with minimum recovery of the motor deficit in the upper limbs, but without significant evolution of the motor deficit in the lower limbs. The patient was discharged on maintenance corticotherapy and immunosuppressive treatment with azathioprine.ConclusionsWe report a very rare association between Guillain–Barré syndrome and acute transverse myelitis triggered by a surgical intervention with general anaesthesia. The overlap of Guillain–Barré syndrome and acute transverse myelitis makes the prognosis for recovery worse, and further studies are needed to establish the first-line therapy in these cases.

Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome Following Obstetric Surgery

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

IntroductionThere are rare reports of the occurrence of acute transverse myelitis and Guillain–Barré syndrome after various surgical procedures and...

Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome Following Obstetric Surgery

Article Category: Case Report

Published Online: Jan 31, 2020

Page range: 74 - 79

Received: Jan 17, 2019

Accepted: Jan 30, 2020

DOI: https://doi.org/10.2478/jccm-2020-0008

Keywords
Guillain–Barré syndrome, acute transverse myelitis, obstetric surgery, tetraparesis, intravenous immunoglobulins, therapeutic plasma exchange

© 2020 Adina Stoian, Anca Motataianu, Zoltan Bajko, Adrian Balasa, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome Following Obstetric Surgery

Article Category: Case Report

Published Online: Jan 31, 2020

Page range: 74 - 79

Received: Jan 17, 2019

Accepted: Jan 30, 2020

DOI: https://doi.org/10.2478/jccm-2020-0008

KeywordsGuillain–Barré syndrome, acute transverse myelitis, obstetric surgery, tetraparesis, intravenous immunoglobulins, therapeutic plasma exchange

© 2020 Adina Stoian, Anca Motataianu, Zoltan Bajko, Adrian Balasa, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
Guillain–Barré syndrome, acute transverse myelitis, obstetric surgery, tetraparesis, intravenous immunoglobulins, therapeutic plasma exchange