Delayed Guillain-Barré Syndrome after Bariatric Surgery: A Report of Three Cases

Table 1

Review of literature: GBS case reports after bariatric surgeries.

Name and author	Year	Country	Study type	Treatment	Outcome
Guillain-Barré-like syndrome after bariatric surgery [5] Natalia Bodunova	2015	Russia	Case report	Vitamin B complex (milgamma), thiamine, pyridoxine, and ferrous sulfate	The neurological symptoms stabilized when treatment was initiated. Over the next several months, the symptoms gradually improved; he required the assistance of a walker for 6 months before his symptoms completely resolved.
Guillain-Barré syndrome and postbariatric surgery polyneuropathies [6] Kanayochukwu J. Aluka	2009	Washington, DC, USA	Case report	Gabapentin, physical therapy	Symptoms gradually improved; she required the assistance of a walker for 6 months before her symptoms completely resolved.
Guillain-Barré syndrome (demyelinating) six weeks after bariatric surgery: a case report and literature review [10] N. Ishaque	2015	Karachi, Pakistan	Case report	Intravenous immunoglobulin (IVIG) and rehabilitation	She had complete recovery on follow-up.
Weakness after gastric bypass [7] Craig G. Chang	2002	Los Angeles and Kansas City, USA	Case series	First patient: plasmapheresis. Therapy was changed to intravenous immunoglobulin G (for 1 year); Second patient: IVIG	First patient: regained some strength in her legs but is confined to a wheelchair because of uncontrollable shaking and persistent weakness of her upper limb.; Second patient: improvement in sensation and strength after second dose of IVIG was discharged to the rehabilitation unit and after 8 weeks was at her baseline premorbid ambulatory status.
Neurological complications of bariatric surgery [9] Hussein A. Algahtani	2016	Jeddah, Saudi Arabia	451 patients who underwent bariatric surgery		Fourteen patients had full recovery from the neurological signs and symptoms; one patient died.
Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery [11] Flavia Costa Nunes Machado	2006	São Paulo, Brazil	Case report	Vitamin supplementation (B1 and B6 vitamin) and IVIG	Rapidly recovered proximal muscle strength.
Neurological complications of bariatric surgery [12] Anne Landais	2014	Abymes, France	Case series	First patient: IV thiamine replacement therapy, followed by intramuscular thiamine daily and physiotherapy; Second patient: IV vitamin B1 and physiotherapy	First patient: after a few days of treatment, there was a slight improvement in gait disorders. She slowly but progressively improved after physiotherapy, and 6 months later, she had nearly completely recovered.; Second patient: there was an improvement of the neurological problems following vitamin B1 supplementation. He was seen 5 months later; motor improvement was equally limited. The patient was able to stand and walk a few meters but needed a wheelchair for long distances.
Rare neurological complication of bariatric surgery: acute motor axonal neuropathy (AMAN), a severe motor axonal form of Guillain-Barré syndrome [13] AF Landais	2014	France	Case report	IVIG	Seven days after initiation of treatment, she was transferred to the rehabilitation department.