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What is not?

 Impossible is not a fact, its an opinion 

Guillian Barre Syndrome-Acute inflammatory Neuropathy

May 21, 2010 by drsalman

Case Sheet

A 25 yearold male presenting to the office with progressive weakness of his lower legs.Weakness started 3 days back when he was getting tired upon walking small distancs.He is also ffeling tingling sensation in both legs.Pateint ha an episode of diarrhealo illness 10 days back which responded to erythromycin.Pateint is a known case of sarcoidosis on chronic prednisoslone therapy.

    On examination pateint is right handed male with flaccid paralysis of both lower limbs with Power1/5There is loss of fine touch sensation uptill mid thigh in both limbs.Ankle and Knee reflexes are slugish in both the limbs.

Case Discussion: 

Usually Viral illness such as CMV,EBV or Bacterial illness such as Campylobacter diarrhea precedes Guillian barre syndrome.

Rules: 

Acute weakness of lower limbs 50

Flaccid wekaness 60

Tingling paresthesias 60

Past history of diarrheal disease 20

Past history of respiratory illness 20

Past history of sarcoidosis,HIV,Hodgins 10

Respiratory paralysis 30

Bladder involvement 10

Ophthalmoplegia 10

Ataxia 10

Areflexia 10

CSF Albuminocytological dissociation 50

EMG Neuropathy 40

If diagnosis GBS then give plasmapheresis/IVIG

 

Questions: 

What is the diagnosis?

What is the best next step in managing this patient?

Which is the confirmatory test??

Which is the best treatment??

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