RCS Khandelwal, Tushar Rathod, Shital Rathod, Arvind Chavan, Chetan Oswal, Kiran Ladkat and Pravin Londhe
16 year old male was operated upon for trauma induced L1 burst fracture with complete paraplegia. On 7th postoperative day patient started developing rapidly evolving bilaterally symmetrical ascending areflexic motor paralysis involving shoulder accompanied by tingling dysesthesias in the upper extremities. Thereafter, he developed lower cranial nerve palsy with facial diaparesis. All relevant haematological & serological tests were not contributory to definite diagnosis and MRI-Spine did not show any abnormality. However, Electrodiagnostic study & CSF examination supported the diagnosis of Guillain-Barre Syndrome (GBS). Patient was subsequently subjected to plasmapheresis but his condition deteriorated and he succumbed to death on 15th postoperative day.
This rare case reports illustrates the importance of watchful expectancy for a neurodeficit that may or may not be related to spine surgery even after critical postoperative period, so that urgent measures can be initiated at the right time in the form of supportive & curative treatment.
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