Affiliations: [a] Department of Physical Medicine and Rehabilitation, Wayne State
University School of Medicine, Detroit Medical Center/Rehabilitation Institute of Michigan,
Detroit, MI, USA | [b] Department of Pediatric Physical Medicine and Rehabilitation,
Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit,
MI, USA | [c] Department of Pediatric Physical Medicine and Rehabilitation,
Children’s Hospital of Michigan, Detroit, MI, USA
Correspondence:
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Corresponding author: Enoch Leung, Department of Physical Medicine and Rehabilitation, Children’s Healthcare of Atlanta, 1001 Johnson Ferry Rd NE, Atlanta, GA 30342, USA. E-mail: enoch.leung@choa.org.
Abstract: BACKGROUND: Hypoxic brain injury results in severe disabilities that require extensive acute inpatient and outpatient rehabilitation to promote maximal functional and cognitive recovery. Brain hypoxemia can result from a multitude of causes, including but not limited to cardiac arrest, drug overdose, and/or shock. While recovery from a hypoxic brain injury alone can be challenging, dealing with concurrent debilitative diagnoses such as Guillain Barré Syndrome (GBS) further complicates the recovery and rehabilitation course. CASE REPORT: The current case study highlights the acute inpatient rehabilitation course of a 16 year old male who presented with cerebral hypoxia secondary to strangulation and subsequently developed GBS. Physical examination of the patient upon rehabilitation consult was inconsistent with a purely hypoxic brain injury, including the absence of rectal tone. This prompted further potential spinal cord injury evaluation and work up, with diagnostic testing confirmatory of GBS. RELEVANCE:This case is important as, to our knowledge from literature review, the first known documented instance of hypoxic brain injury complicated by GBS. Moreover, it highlights the importance of identifying all potential causes of functional disability, particularly when presented with physical exam findings inconsistent with chief diagnosis, in order to maximize functional recovery and rehabilitative gains during acute inpatient rehabilitation.
