Guillain-Barré syndrome and related neuropathies post-bariatric surgery: a systematic review of clinical cases and outcomes

Bariatric surgery is a widely used treatment for morbid obesity, but it can lead to neurological complications, including Guillain–Barré Syndrome (GBS), a rare immune-mediated polyneuropathy. The mechanisms underlying post-bariatric GBS remain unclear, and no comprehensive review has evaluated its incidence, risk factors, and outcomes. This systematic review synthesizes available clinical data to assess the relationship between bariatric surgery and GBS, focusing on its presentation, diagnosis, and management. A systematic literature search was conducted in Web of Science, PubMed, and Scopus following PRISMA guidelines. Studies reporting GBS following bariatric surgery were included. Data extraction focused on demographics, clinical presentation, laboratory findings, treatment approaches, and outcomes. Study quality was assessed using the Joanna Briggs Institute (JBI) tool. GBS cases were predominantly reported in female patients, with symptom onset occurring within weeks to months post-surgery. The most common clinical features included ascending motor weakness, sensory disturbances, hyporeflexia, and autonomic dysfunction. Laboratory findings showed elevated cerebrospinal fluid protein and abnormal nerve conduction studies. Patients were treated with intravenous immunoglobulin (IVIG), plasmapheresis, and nutritional supplementation, particularly thiamine and vitamin B12. Recovery varied; some patients regained full function, while others experienced persistent neurological deficits or severe complications such as respiratory failure. GBS is a rare but serious post-operative complication of bariatric surgery, potentially linked to immune dysregulation and nutritional deficiencies. Early recognition and prompt intervention are critical. Further research is needed to clarify underlying mechanisms, optimize treatment, and improve preventive strategies.