scholarly journals Guillain-Barré Syndrome Presenting as an Acute Back Pain

Cureus ◽  
2021 ◽  
Author(s):  
Nicholas T Hodgeman ◽  
Lacy E Lowry ◽  
Sky D Graybill
Keyword(s):  
Back Pain ◽  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
Acute Back Pain ◽  
Guillain Barré

scholarly journals Guillain-Barré syndrome and Low back pain: two cases and literature review

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 503-508
Author(s):  
Xianjun Ding ◽  
Hong Jiang ◽  
Xingyue Hu ◽  
Hong Ren ◽  
Huaying Cai
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina ◽  
Guillain Barre Syndrome ◽  
Low Back ◽  
Mri Features ◽  
Prominent Symptom ◽  
Guillain Barré Syndrome ◽  
Lumbar Mri ◽  
Guillain Barré

AbstractPurpose. To describe the clinical, electrophysiological, and lumbar magnetic resonance imaging (MRI) features of two cases of atypical Guillain-Barré syndrome (GBS). Methods We reported two GBS variant cases with initial and prominent symptoms of low back pain. We analysed their clinical, electrophysiological, and lumbar MRI features. Results Two patients with GBS reported low back pain as the initial and prominent symptom, which was not accompanied by limb weakness. The electrophysiological study showed abnormal F-waves in the common peroneal and tibial nerves, and acute polyradiculoneuropathy in the cauda equina. Examination of the cerebrospinal fluid (CSF) showed albuminocytologic dissociation. Serum was positive for GQ1b-IgM antibodies. Lumbar MRI showed gadolinium enhancement of the nerve roots and cauda equina. A standard regime of intravenous immunoglobulin markedly alleviated the low back pain. Conclusions Low back pain caused by GBS should be differentiated from other diseases. This initial or early prominent symptom may delay the diagnosis of GBS; therefore, it is important to conduct a detailed electrophysiological, CSF, and gadolinium-enhanced lumbar MRI analysis.

scholarly journals Guillain-Barre syndrome with concurrent posterior reversible encephalopathy syndrome and hyponatraemia: mere coincidence or rare coexistence

2019 ◽  
Vol 12 (7) ◽  
pp. e229749 ◽  
Author(s):  
Carley Drye ◽  
Subhasish Bose ◽  
Samata Pathireddy ◽  
Narothama Reddy Aeddula
Keyword(s):  
Back Pain ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Manifestations ◽  
Guillain Barre Syndrome ◽  
Posterior Reversible Encephalopathy ◽  
Persistent Symptoms ◽  
Guillain Barré Syndrome ◽  
History Of ◽  
Guillain Barré ◽  
Reversible Encephalopathy

A 61-year-old Caucasian woman with a history of hypertension presented with a week’s history of confusion falls and back pain was found to have hyponatraemia from secretion of antidiuretic hormone and treated appropriately. Given her persistent symptoms, despite a normal CT head on presentation, an MRI head was obtained, showing vasogenic oedema in line with posterior reversible encephalopathy syndrome (PRES). Despite aggressive antihypertensives and supportive measures, unfortunately, her condition deteriorated, with increased confusion, new left-sided flaccid paresis, paraesthesias and worsening of the back pain. Following further testing including a cerebrospinal fluid analysis, finally diagnosed with an atypical presentation of Guillain-Barre syndrome (GBS), and prompt management with intravenous immunoglobulins was initiated. She recovered clinically and returned to near-normal function on follow-up. We use this case to suggest the importance of dysautonomia in GBS and various clinical manifestations it can present with, including PRES and hyponatraemia.

Masquerading Guillain-Barré syndrome: uncommon, in-hospital presentation of Miller-Fisher syndrome shadowed by secondary diseases

2021 ◽  
Vol 14 (2) ◽  
pp. e239133
Author(s):  
Viswanathan Pandurangan ◽  
Sujay Prabhath Dronamraju ◽  
Srinivasan Ramadurai ◽  
Preetam Arthur
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Extraocular Muscles ◽  
Guillain Barre Syndrome ◽  
Herniated Disc ◽  
Low Back ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
New Onset

Presentation of severe pain syndromes prior to onset of motor weakness is an uncommon but documented finding in patients with Guillain-Barré syndrome (GBS). Sciatica in GBS is a difficult diagnosis when patients present with acute radiculopathy caused by herniated disc or spondylolysis. A middle-aged woman was admitted for severe low back pain, symptomatic hyponatraemia, vomiting and constipation. On further investigation, she was diagnosed with radiculopathy, and appropriate treatment was initiated. Brief symptomatic improvement was followed by new-onset weakness in lower limbs, which progressed to involve upper limbs and right extraocular muscles. With progressive, ascending, new-onset motor and sensory deficits and laboratory evidence of demyelination by Nerve Conduction Study, a diagnosis of variant GBS was made. She was treated with intravenous immunoglobulin 2 g/kg over 5 days. The presentation of severe low back pain that was masking an existing aetiology and possible dysautonomia and the unilateral right extraocular muscles instead of bilateral make our case unique and rare.

Guillain-Barré Syndrome with Rapid Onset and Autonomic Dysfunction Following First Dose of Pfizer-BioNTech COVID-19 Vaccine: A Case Report

2022 ◽  
pp. 194187442110652
Author(s):  
Tyler Ashford Lanman ◽  
Connie Wu ◽  
Helen Cheung ◽  
Neelam Goyal ◽  
Maxwell Greene
Keyword(s):  
Back Pain ◽  
Vaccine Dose ◽  
Rapid Onset ◽  
Guillain Barre Syndrome ◽  
Lower Extremity Weakness ◽  
Sensorimotor Polyneuropathy ◽  
Guillain Barré Syndrome ◽  
Neurological Exam ◽  
Severe Back Pain ◽  
Guillain Barré

Guillain-Barre syndrome (GBS) is an immune-mediated, often post-infectious illness manifesting as an acute, characteristically monophasic, polyradiculoneuropathy. We present a case of GBS with autonomic involvement following an mRNA-based vaccine against SARS-COV2 (Pfizer/BioNTech mRNA-BNT162b2). A 58-year-old woman presented with fatigue, distal extremity paresthesias, and severe back pain within 3 days after receiving her first vaccine dose. She developed worsening back pain and paresthesias in distal extremities which prompted her initial presentation to the hospital. By the third week post-vaccine, she developed increasing gait unsteadiness, progression of paresthesias, and new autonomic symptoms including presyncopal episodes and constipation. Neurological exam showed bilateral distal predominant lower extremity weakness, decreased sensation in a length-dependent pattern, and areflexia. EMG/NCS showed a diffuse sensorimotor polyneuropathy with mixed demyelinating and axonal features consistent with GBS. She was treated with 2 g/kg of IVIG over 3 days and also received prednisone 60 mg daily for 3 days for severe back pain, with improvement of symptoms. This possible association with mRNA-based vaccination expands the potential triggers for an autoimmune-based attack on the peripheral nervous system.

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