Jaseng Spine and Joint Research Institute
paper32_the-clinical-observation

Guillain-Barré syndrome mistaken for a common spinal disorder: a case report

paper31_guillain-barre-syndrome

 

CONTEXT:
Many patients with musculoskeletal issues seek traditional Korean medicine or complementary and alternative medicine (CAM) to treat or help deal with their health conditions. Practitioners and patients should be aware of diseases that can exhibit similar symptoms, consequently complicating diagnosis and treatment.
OBJECTIVE:
The study intended to examine a case of Guillain-Barré syndrome (GBS), in which the patient presented with back pain, leg pain, and weakness that gave cause for diagnostic error at onset.
DESIGN:
The research team has reported a case study.
SETTING:
The study was conducted at Jaseng Hospital of Korean Medicine in Seoul, Korea.
PARTICIPANT:
After initially being prescribed back surgery for lumbar disc herniation, as confirmed by lumbar magnetic resonance imaging (MRI) at a previous hospital, a 54-y-old female with low back and leg pain as her chief complaint chose to transfer to a Korean medicine hospital for nonsurgical treatment.
INTERVENTION:
The patient became nonambulatory owing to a sudden decrease in muscle strength during admission and underwent a cervical MRI to assess for cervical myelopathy because she developed additional neck pain and upper-limb symptoms. She then was diagnosed with GBS and received a regime of symptomatic treatment with CAM, including acupuncture, electroacupuncture, pharmacopuncture, and herbal medicine.
RESULTS:
The cervical MRI results showed that the symptoms were not due to myelopathy or radiculopathy, and GBS was suspected because of the progressive ascending weakness, absence of myotatic reflexes in the lower limbs, and preceding flu-like symptoms. The patient showed swift recuperation after the CAM treatments, recovering motor strength and ambulation.
CONCLUSIONS:
A seemingly typical patient with musculoskeletal symptoms may turn out to have a completely different pathology, and clinicians should keep such potential confounders and comorbidities in mind when diagnosing patients.