Can surgery be a precursor to Guillain-Barre Syndrome?

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Guillain-Barre syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system (1) and resulting in muscle weakness, and in severe cases, paralysis. The causative agent of GBS is yet unknown. There have been cases wherein previous infections, trauma, and surgeries have triggered GBS (2).

Study –

According to a recent study carried out by a team of researchers from Mayo Clinic in Rochester, it is strongly suggested that the probability of suffering from GBS increases in patients who have had surgery in recent past; this was previously considered as just one of the triggering factors. This study was led by Dr. Sara Hocker and examined the potential triggers of GBS within the first 8 weeks of undergoing a surgical procedure.

Researchers examined the medical records of patients that received treatment for GBS at the Mayo Clinic in the past 20 years, from January 1995 to June 2014. For this study, 208 patients with GBS were considered, having an average age of 55 years. It was seen that these patients had mostly undergone either gastrointestinal, cardiac, or orthopedic surgeries.(3) There have been cases in the past wherein patients undergoing bariatric surgery or spine surgery have suffered from GBS postsurgery (4,5).

 It was seen that around 58% were given general anesthesia and others were given local.  The results of this study showed that 15% of the patients who suffered from GBS have had undergone some surgical procedure within 60 days of developing the disease. Moreover, it was seen that 31 of the 208 patients suffering from GBS, had developed it within 8 weeks of undergoing the surgery. Postsurgical GBS was generally seen at an average age of 63 years, and was more common in the male population accounting for 65% of the affected population.

The probability of suffering from GBS post-surgery increased 7 folds in people suffering from cancer after they undergo surgery as compared to those who do not have cancer.(3)

Patients whose immune systems are compromised like in autoimmune diseases are at a greater risk of developing GBS postsurgery than those with a healthy immune system. The chances of suffering from GBS increases 5 folds postsurgery if the patient is already suffering from ulcerative colitis or type 1 diabetes. (3)          

From the 31 patients who developed GBS postsurgery, 19 (61%) of them had associated malignancy and 9 patients (29%) suffered from autoimmune conditions. The results of this study are published in Neurology Clinical Practice. (3)

Conclusion –

Occurrence of Guillain-Barré syndrome postsurgery is noted to be rare, with only a few amongst thousands of people undergoing surgery being affected by it. However, it is seen that those with a compromised immune system, be it cancer or any autoimmune disease, are at greater risk of GBS.

Credit: Dr. Rachita on behalf of Borderless Access

Copyright © 2016 BorderlessAccess

Reference Sources:

  1. Meena AK, Khadilkar SV, Murthy JMK. Treatment guidelines for Guillain–Barré Syndrome. Annals of Indian Academy of Neurology
  2. Yang B, Lian Y, Liu Y, Wu BY, Duan RS. A retrospective analysis of possible triggers of Guillain-Barre syndrome

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