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Case Reports
. 2021 Feb 16;9(5):1096-1102.
doi: 10.12998/wjcc.v9.i5.1096.

Severe lumbar spinal stenosis combined with Guillain-Barré syndrome: A case report

Dan-Feng Xu  1 , Bing Wu  1 , Jin-Xin Wang  1 , Jian Yu  1 , Jian-Xin Xie  2
Affiliations
Case Reports

Severe lumbar spinal stenosis combined with Guillain-Barré syndrome: A case report

Dan-Feng Xu et al. World J Clin Cases. .

Abstract

Background: Guillain-Barré syndrome (GBS) is a rare disorder that typically presents with ascending weakness, pain, paraesthesias, and numbness, which mimic the findings in lumbar spinal stenosis. Here, we report a case of severe lumbar spinal stenosis combined with GBS.

Case summary: A 70-year-old man with a history of lumbar spinal stenosis presented to our emergency department with severe lower back pain and lower extremity numbness. Magnetic resonance imaging confirmed the diagnosis of severe lumbar spinal stenosis. However, his symptoms did not improve postoperatively and he developed dysphagia and upper extremity numbness. An electromyogram was performed. Based on his symptoms, physical examination, and electromyogram, he was diagnosed with GBS. After 5 d of intravenous immunoglobulin (0.4 g/kg/d for 5 d) therapy, he gained 4/5 of strength in his upper and lower extremities and denied paraesthesias. He had regained 5/5 of strength in his extremities when he was discharged and had no symptoms during follow-up.

Conclusion: GBS should be considered in the differential diagnosis of spinal disorder, even though magnetic resonance imaging shows severe lumbar spinal stenosis. This case highlights the importance of a careful diagnosis when a patient has a history of a disease and comes to the hospital with the same or similar symptoms.

Keywords: Case report; Diagnose; Guillain-Barré syndrome; Lower back pain; Lumbar spinal stenosis; Paraesthesias.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflicts of interest to report.

Figures

Figure 1
Figure 1
X-rays showed degenerative changes of the lumbar spine and the L4 vertebral body had slipped forward slightly. Preoperative anterior-posterior (A) and lateral (B) radiographs of the spine demonstrating degenerative changes of the lumbar spine and that the L4 vertebral body had slipped forward slightly. Postoperative anterior-posterior (C) and lateral (D) radiographs of the spine demonstrating the L4-5 instrumented fusion with bilateral segmental pedicle screws-rods fixation and interbody cage devices.
Figure 2
Figure 2
Sagittal view of T2 weighted magnetic resonance imaging. The arrow shows severe canal stenosis at L4/5.
See this image and copyright information in PMC

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