Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Atypical Guillain-Barr$\acute{e}$ Syndrome Misdiagnosed as Lumbar Spinal Stenosis

  • Jung, Dae Young (Department of Neurosurgery, Dongguk University College of Medicine, Dongguk University Ilsan Hospital) ;
  • Cho, Keun-Tae (Department of Neurosurgery, Dongguk University College of Medicine, Dongguk University Ilsan Hospital) ;
  • Lee, Seung Chul (Department of Emergency Medicine, Dongguk University College of Medicine, Dongguk University Ilsan Hospital)
  • Received : 2012.08.20
  • Accepted : 2013.04.08
  • Published : 2013.04.28
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Abstract

Guillain-Barr$\acute{e}$ syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy. In typical cases, the first symptoms of GBS are pain, numbness, paresthesia, weakness in the limbs. Autonomic involvement is common and causes urinary retention and ileus. Much of these symptoms overlap with those of lumbar spinal stenosis. Therefore, correct diagnosis of GBS in a patient with symptomatic lumbar spinal stenosis or in a patient with atypical manifestations of GBS can be difficult, especially early in the course of GBS. Here, we report on a case of atypical GBS in a 74-year-old previously healthy patient with lumbar spinal stenosis and discuss the differential diagnosis of the GBS and lumbar spinal stenosis.

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References

  1. Abai S, Kim SB, Kim JP, Lim YJ : Guillain-barre syndrome combined with acute cervical myelopathy. J Korean Neurosurg Soc 48 : 298-300, 2010 https://doi.org/10.3340/jkns.2010.48.3.298
  2. Gurwood AS, Drake J : Guillain-Barre syndrome. Optometry 77 : 540-546, 2006 https://doi.org/10.1016/j.optm.2006.06.014
  3. Hughes RA, Cornblath DR : Guillain-Barre syndrome. Lancet 366 : 1653-1666, 2005 https://doi.org/10.1016/S0140-6736(05)67665-9
  4. Johnsson KE : Lumbar spinal stenosis. A retrospective study of 163 cases in southern Sweden. Acta Orthop Scand 66 : 403-405, 1995 https://doi.org/10.3109/17453679508995574
  5. Johnsson KE, Sass M : Cauda equina syndrome in lumbar spinal stenosis : case report and incidence in Jutland, Denmark. J Spinal Disord Tech 17 : 334-335, 2004 https://doi.org/10.1097/01.bsd.0000095828.98982.6c
  6. Kobayashi S, Uchida K, Takeno K, Baba H, Suzuki Y, Hayakawa K, et al. : Imaging of cauda equina edema in lumbar canal stenosis by using gadolinium-enhanced MR imaging : experimental constriction injury. AJNR Am J Neuroradiol 27 : 346-353, 2006
  7. Logullo F, Manicone M, Di Bella P, Provinciali L : Asymmetric Guillain-Barré syndrome. Neurol Sci 27 : 355-359, 2006 https://doi.org/10.1007/s10072-006-0710-z
  8. Mulkey SB, Glasier CM, El-Nabbout B, Walters WD, Ionita C, McCarthy MH, et al. : Nerve root enhancement on spinal MRI in pediatric Guillain-Barré syndrome. Pediatr Neurol 43 : 263-269, 2010 https://doi.org/10.1016/j.pediatrneurol.2010.05.011
  9. Pithadia AB, Kakadia N : Guillain-Barre syndrome (GBS). Pharmacol Rep 62 : 220-232, 2010 https://doi.org/10.1016/S1734-1140(10)70261-9
  10. Ruts L, Drenthen J, Jongen JL, Hop WC, Visser GH, Jacobs BC, et al. : Pain in Guillain-Barre syndrome : a long-term follow-up study. Neurology 75 : 1439-1447, 2010 https://doi.org/10.1212/WNL.0b013e3181f88345
  11. Siebert E, Pruss H, Klingebiel R, Failli V, Einhäupl KM, Schwab JM : Lumbar spinal stenosis : syndrome, diagnostics and treatment. Nat Rev Neurol 5 : 392-403, 2009 https://doi.org/10.1038/nrneurol.2009.90
  12. Storm PB, Chou D, Tamargo RJ : Lumbar spinal stenosis, cauda equina syndrome, and multiple lumbosacral radiculopathies. Phys Med Rehabil Clin N Am 13 : 713-733, ix, 2002 https://doi.org/10.1016/S1047-9651(02)00013-X
  13. van Doorn PA, Ruts L, Jacobs BC : Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome. Lancet Neurol 7 : 939-950, 2008 https://doi.org/10.1016/S1474-4422(08)70215-1
  14. Yikilmaz A, Doganay S, Gumus H, Per H, Kumandas S, Coskun A : Magnetic resonance imaging of childhood Guillain-Barre syndrome. Childs Nerv Syst 26 : 1103-1108, 2010 https://doi.org/10.1007/s00381-010-1197-8
  15. Yuki N, Kokubun N, Kuwabara S, Sekiguchi Y, Ito M, Odaka M, et al. : Guillain-Barre syndrome associated with normal or exaggerated tendon reflexes. J Neurol 259 : 1181-1190, 2012 https://doi.org/10.1007/s00415-011-6330-4

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