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Case Report

Guillain-Barre Syndrome: Diagnostic Challenge in ED to Rule Out Other Causes of Polyneuropathy

Kalita R.* , Kalita R.* , Kaul M.* , Das I.** , Datta K.***

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Indian Journal of Emergency Medicine 2(1):p 69-71, Jan-Jun 2016. | DOI: DOI: http://dx.doi.org/10.21088/ijem.2395.311X.2116.16

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Abstract

 Guillain-Barre Syndrome (GBS) is a immune mediated peripheral nerve myelin sheath destruction usually presented with bilateral lower extremity pain, worsening dysphagia, subsequent ascending symmetric weakness, and loss of deep tendon reflexes. The diagnosis is usually made based on the signs and symptoms, through the exclusion of alternative causes, and supported by tests such as nerve conduction

studies and examination of the cerebrospinal fluid. Patients having atypical presentation, incomplete weakness, and some inconsistencies in their physical examination are diagnosed as having some psychological cause and the diagnosis is very difficult . In severe cases, there is risk of ventilator failure associated with cardiac instability , so early diagnosis and prompt referral should be needed. This article presents a case of GBS who presented in emergency with complain of dysphagia for 20 days and dyspnea specially on neck movement associated with quadriparesis and autonomic disturbances without involvement of sensory system.
 
Keywords: Neuropathy; Dysautonomia; GBS; Cerebrospinal; Ascending Weakness.

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DOI: DOI: http://dx.doi.org/10.21088/ijem.2395.311X.2116.16

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