Abstract：
STUDY DESIGN:A case report of a Guillain-Barré syndrome (GBS) variant presenting in a patient with a high cervical spinal cord injury (SCI). OBJECTIVES:To illustrate a clinical presentation of GBS in an individual with chronic SCI. SETTING:Vancouver General Hospital, Vancouver, BC, Canada. METHODS/RESULTS:A 31-year-old man with chronic C2 AIS B (American Spinal Injury Association Impairment Scale) SCI and diaphragmatic pacing presented with respiratory failure with sepsis. His sepsis resolved with antibiotic therapy, but he continued to have autonomic instability and was unable to be weaned off his ventilator. Concurrently he developed flaccidity and facial diplegia. Investigations including nerve conduction studies and cerebrospinal fluid analysis prompted a diagnosis of acute motor-sensory axonal neuropathy, a variant of Guillian-Barré syndrome. Owing to ongoing autonomic instability, he was treated with intravenous immunoglobulin. His autonomic dysfunction resolved and he regained some facial muscle function, but 6 months post injury he remained dysphagic and required 24-h ventilator support. CONCLUSION:Careful neurological reassessment prompted the diagnosis of acute polyradiculoneuropathy following respiratory sepsis as the root cause of diaphragmatic pacer failure and autonomic instability.
journal_name
Spinal Cordjournal_title
Spinal cordauthors
Grant C,Briscoe N,Mezei M,Krassioukov Adoi
10.1038/sc.2010.84subject
Has Abstractpub_date
2011-03-01 00:00:00pages
480-1issue
3eissn
1362-4393issn
1476-5624pii
sc201084journal_volume
49pub_type
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