Guillain-Barré Syndrome Following Orthopedic Trauma and Surgical Fixation: A Case of Acute Inflammatory Demyelinating...

Guillain-Barré syndrome (GBS) is an acute inflammatory immune-mediated polyradiculoneuropathy characterized by rapidly progressive ascending weakness, generalized areflexia, and varying degrees of cranial nerve involvement. Although antecedent respiratory and gastrointestinal infections are the most commonly seen triggers, an association between surgery and GBS has increasingly been recorded in recent years. Recognition in postoperative patients may be delayed because neurological deficits are commonly attributed to postoperative complications, prolonged immobility, metabolic abnormalities, or medication-related adverse effects. Although GBS following orthopedic surgery has been increasingly reported in recent years, it remains an important diagnostic challenge because postoperative neurological deficits are frequently attributed to surgical, metabolic, or medication-related causes, resulting in delayed diagnosis and treatment. We report the case of a 19-year-old male who developed rapidly progressive ascending quadriparesis with areflexia and right lower motor neuron facial palsy around 10 days after open reduction and internal fixation for left tibia and fibula fractures. Nerve conduction studies demonstrated demyelinating sensorimotor polyradiculoneuropathy consistent with the acute inflammatory demyelinating polyradiculoneuropathy type of GBS. Cerebrospinal fluid analysis showed albuminocytological dissociation. The patient was treated with intravenous immunoglobulin therapy and demonstrated remarkable neurological recovery with near-complete restoration of motor function at follow-up. This case highlights the diagnostic challenges associated with postoperative GBS and emphasizes the importance of maintaining a high index of suspicion in patients presenting with rapidly progressive weakness after orthopedic procedures. Early electrophysiological evaluation and prompt immunotherapy can result in excellent neurological recovery.