Case Reports in Clinical Practice (Jan 2023)
A Missed Diagnosis of Guillain-Barre Syndrome Masquerading as Stroke in an Acute Medical Unit: A Case Report
Abstract
An elderly woman aged 66 presented to a general hospital with left-sided facial paresis, bilateral lower limb weakness, and back pain. After undergoing clinical assessments and investigations, she was diagnosed and treated as a case of acute stroke. Two weeks later, she was repatriated to our hospital for neuro-rehabilitation. Unconvinced, we revisited her clinical history and, after a thorough physical examination, made a clinical diagnosis of Guillain- Barre Syndrome (GBS), i.e., confirmed by electrophysiological studies. She was treated with intravenous immunoglobulin and made a complete recovery 6 weeks later. This case highlights an infrequent presentation of GBS as a stroke-mimic. It re-emphasizes the need to maintain a high index of clinical suspicion for similar expressions, especially in busy acute medical units. Such cases are easily missed if basic clinical skills, such as good history- taking and thorough physical examination, are glossed over. Despite time constraints, these skills are indispensable in clinical practice.
