Clinical Follow-up of a Patient with Muscle Weakness During the Postoperative Intensive Care Period
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Case Report
P: 192-195
December 2021

Clinical Follow-up of a Patient with Muscle Weakness During the Postoperative Intensive Care Period

J Turk Soc Intens Care 2021;19(4):192-195
1. İzzet Baysal Devlet Hastanesi, Yoğun Bakım Kliniği, Bolu, Türkiye
2. Zonguldak Atatürk Devlet Hastanesi, Yoğun Bakım Kliniği, Zonguldak, Türkiye
3. Afyon Kocatepe Üniversitesi Tıp Fakültesi, Anestezi ve Reanimasyon Anabilim Dalı, Afyon, Türkiye
4. Aydın Adnan Menderes Üniversitesi Tıp Fakültesi, Anestezi ve Reanimasyon Anabilim Dalı, Aydın, Türkiye
No information available.
No information available
Received Date: 18.05.2021
Accepted Date: 11.08.2021
Publish Date: 17.11.2021
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ABSTRACT

The patient underwent intensive care after an acute abdominal surgery due to intestinal perforation. The patient was examined for postoperative muscle weakness, and the differential diagnosis was studied. Guillain-Barré syndrome is an acute inflammatory demyelinating polyneuropathy. Infection, surgery, and transplantation have been cited in its etiology. History, clinical examination and follow-up, laboratory tests, and electrophysiological studies are important in its diagnosis, as well as differential diagnosis. Intravenous immunoglobulin and plasmapheresis are the mainstays of care, and supportive care is important for long-term treatment. In this case report, an intensive care unit approach was discussed, in which the surgical paradigm and gastrointestinal stromal tumor were thought of as a rare paraneoplastic complication.

Keywords:
Guillain-Barré syndrome, intravenous immunoglobulin, plasmapheresis, gastrointestinal stromal tumor

References

1
Hughes RA, Cornblath DR. Guillain-Barré syndrome. Lancet 2005;366:1653-66.
2
Zochodne DW, Bolton CF, Wells GA, Gilbert JJ, Hahn AF, Brown JD, et al. Critical illness polyneuropathy. A complication of sepsis and multiple organ failure. Brain 1987;110:819-41.
3
Helliwell TR, Coakley JH, Wagenmakers AJ, Griffiths RD, Campbell IT, Green CJ, et al. Necrotizing myopathy in critically-ill patients. J Pathol 1991;164:307-14.
4
Lacomis D, Giuliani MJ, Van Cott A, Kramer DJ. Acute myopathy of intensive care: clinical, electromyographic, and pathological aspects. Ann Neurol 1996;40:645-54.
5
Sanders DB. Clinical impact of single-fiber electromyography. Muscle Nerve Suppl 2002;11:S15-20.
6
Sanders DB. Electrophysiologic study of disorders of neuromuscular transmission. In: Aminoff MJ (Ed) Electrodiagnosis in Clinical Neurology. 3. Edition, New York: Churchill Livingstone Inc; 1992. p. 347-8.
7
Robin SH. Poliomyelitis and postpolio syndrome. B Med Journ 2005;330:1314-8.
8
Levitt JO. Practical aspects in the management of hypokalemic periodic paralysis. J Transl Med 2008;6:18.
9
Yuki N, Hartung HP. Guillain-Barré syndrome. N Engl J Med 2012;366:2294-304.
10
Jacobs BC, Rothbarth PH, van der Meché FG, Herbrink P, Schmitz PI, de Klerk MA, et al. The spectrum of antecedent infections in Guillain-Barré syndrome: a case-control study. Neurology 1998;51:1110-5.
11
O’Leary CP, Willison HJ. The role of antiglycolipid antibodies in peripheral neuropathies. Curr Opin Neurol 2000;13:583-8.
12
Özyurt Y, Süslü H, Erkal H, Arslan G, Ersoy G, Çıplaklıgil E, et al. Miller-Fisher Sendromu. Yoğun Bakım Dergisi 2003;3:200-3.
13
Huang SL, Qi HG, Liu JJ, Huang YJ, Xiang L. A Rare Complication of Spine Surgery: Guillain-Barré Syndrome. World Neurosurg 2015;84:697-701.
14
Hiew FL, Rajabally YA. Malignancy in Guillain-Barré syndrome: A twelve-year single-center study. J Neurol Sci 2017;375:275-8.
15
Anderson D, Beecher G, Steve TA, Jen H, Camicioli R, Zochodne DW. Neurological Nuance: Hodgkin lymphoma presenting with Guillain-BarrÉ syndrome. Muscle Nerve 2017;55:601-4.
16
Schneiderbauer R, Schneiderbauer M, Wick W, Enk AH, Haenssle HA, Hassel JC. PD-1 Antibody-induced Guillain-Barré Syndrome in a Patient with Metastatic Melanoma. Acta Derm Venereol 2017;97:395-6.
17
Ferrufino E, Camarasa A, Chiner E. Guillain-Barre syndrome as an initial manifestation of small cell lung carcinoma. Arch Bronconeumol 2011;47:106-11.
18
Takane K, Midorikawa Y, Yamazaki S, Kajiwara T, Yoshida N, Kusumi Y, et al. Gastointestinal stromal tumor with nephrotic syndrome as a paraneoplastic syndrome: as a case report. J Med Case Rep 2014;8:108.
19
Alan C, Scott S, Crystal K, Ming J, Luay M. An Atypical Case of Guillain-Barre Syndrome Associated With Gastrointestinal Stromal Tumor. Program No. P837. World Congress of Gastroenterology at ACG2017 Meeting Abstracts.Orlando, FL: American College of Gastroenterology.
20
Cheng Q, Jiang GX, Fredrikson S, Link H, de Pedro-Cuesta J. Increased incidence of Guillain-Barré syndrome postpartum. Epidemiology 1998;9:601-4.
21
Asbury AK, Cornblath DR. Assessment of current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol 1990(Suppl 27):S21-4.
22
Sharshar T, Chevret S, Bourdain F, Raphaël JC; French Cooperative Group on Plasma Exchange in Guillain-Barré Syndrome. Early predictors of mechanical ventilation in Guillain-Barré syndrome. Crit Care Med 2003;31:278-83.
23
Meena AK, Khadilkar SV, Murthy JM. Treatment guidelines for Guillain-Barré Syndrome. Ann Indian Acad Neurol 2011;14(Suppl 1):S73-81.
24
Hughes RA, Brassington R, Gunn AA, van Doorn PA. Corticosteroids for Guillain-Barré syndrome. Cochrane Database Syst Rev 2016;10:CD001446.
25
Hughes RA, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst Rev 2014;2014:CD002063.
26
Chevret S, Hughes RA, Annane D. Plasma exchange for Guillain-Barré syndrome. Cochrane Database Syst Rev 2017;2:CD001798.