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Postoperative Guillain-Barré Syndrome, Arachnoiditis, and Epidural Analgesia
  1. Samuel K. Rosenberg, M.D.* and
  2. Brett R. Stacey, M.D
  1. *Department of Anesthesiology, Case Western Reserve School of Medicine, Cleveland, Ohio and the
  2. Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennyslvania
  1. Reprint requests: Samuel Rosenberg, M.D., Department of Anesthesiology, University Hospitals in Cleveland, 2074 Abington Road, Cleveland, OH 44106.

Abstract

Background and Objectives A 58-year-old man developed progressive neurologic symptoms following a surgical procedure and postoperative epidural analgesia.

Methods Neurologic evaluation, magnetic resonance imaging, computed tomography, and electromyography indicated the presence of both arachnoiditis and Guillain-Barré syndrome. The patient was treated with plasmapheresis and methylprednisone.

Results The patient began to show clinical and electromyographic recovery but was lost to follow-up after his transfer to a rehabilitation facility.

Conclusions Anesthesiologists should be aware of the possible postoperative occurrence of rare neurologic disorders, both in patients who have received epidural analgesia and in those who have not, but they should not be deterred from using epidural analgesia by this isolated case.

  • Guillain-Barré syndrome
  • arachnoiditis
  • epidural anesthesia
  • electromyography
  • postoperative complications

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Footnotes

  • Case reported occurred at the University of Pittsburgh Medical Center.