Guillain-Barre Syndrome Mimicked by Spinal Stenosis in A Case of Chronic Prolapsed Intervertebral Disc: A Case Report

Abstract

Background: Guillain-Barre Syndrome (GBS) is a rare acute autoimmune polyneuropathy which is usually preceded by infections. It can be a difficult diagnosis to establish especially in patients with underlying neurological comorbidities. The Case: A 54-year-old gentleman with a long history of prolapsed intervertebral disc presented with progressive asymmetrical onset tetraparesthesia for 4 weeks, associated with progressive paraparesis for 2 weeks. The diagnosis of GBS was missed initially due to missing relevant history of prior infection, atypical presentation (asymmetrical limb weakness), and radiological evidence of spinal stenosis. Nerve conduction study, cerebrospinal fluid analysis, and antiganglioside antibodies later confirm the diagnosis of GBS. The patient was started on intravenous immunoglobulin and achieved significant improvement. He was discharged a week later and transferred to a rehabilitation hospital. Conclusion: GBS should not be excluded a priori diagnostic tests and lab work in neurological patients. Physicians should avoid over-rely on radiological findings to conclude a diagnosis. Comprehensive history and examination to discover reasons behind patients' presentations should be prioritized when developing a diagnosis.

Keywords

• Guillain-Barre Syndrome
• Polyradiculoneuropathy
• Intervertebral Disc Displacement
• Spinal Stenosis