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Guillain-Barré syndrome after epidural anesthesia

Direct nerve root damage may trigger disease

From the Departments of Neurology (Drs. Steiner, Argov, and Abramsky) and Internal Medicine, Mount Scopus (Dr. Cahan). Hadassah University Hospital and Hebew University-Hadassah Medical School, Jerusalem, Israel.

Guillain-Barré syndrome (GBS) appeared in four patients 1 to 2 weeks after epidural anesthesia. In all patients, clinical diagnosis was confirmed by CSF findings and nerve conduction velocity studies. Although epidural anesthesia has not been listed as an antecedent event in GBS, evidence for the relationship has been previously reported. Interaction between the anesthetic agents and peripheral nervous system myelin or local trauma to roots may initiate a cascade of immunologic events that result in the demyelinating neuropathy.

Address correspondence and reprint requests to Dr. Striner, Department of Neurology, Hadassah University Hospital. Jerusalem, Israel 91120.

Accepted for publicatim January 15, 1985

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