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Guillain-Barre syndrome


Step 1: View clinicals

An 18 year old girl presents with paresthesia of both lower limbs, which progressed into weakness and difficulty in walking over a period of 3 days. There was no bladder or bowel incontinence, or a history of trauma. She experienced an upper respiratory tract infection 3 weeks earlier. Her medical history is unremarkable.

Step 2: Order all relevant investigations

Stool cultures for poliovirus

Negative for poliovirus

Lumbar puncture

Appearance: clear Polymorphs: nil (< 5) Gram stain: negative Glucose: 70 mg/dL (50 - 80) Protein: 50 mg/dL (15 mg/dl - 60 mg/dl)

Nerve conduction studies

Nerve conduction studies of both lower limbs are normal.

Serum Electrolytes

Na+: 137 mEq/l (135 - 145) K+: 4.2 mEq/l (3.5 - 5.5) Cl-: 101 mEq/l (97 - 105)

Step 3: Select appropriate management

IV Immunoglobulin
ICU care

Score: ★★☆