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

BACKGROUNDGuillain-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 SUMMARYA 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.CONCLUSIONGBS 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.     

Morbus Menière und zervikale Syndrome

Summary The history of the patient is very important. In cervical syndroms typical pain in neck, shoulder and arm are present, often combined with occipital headache and paraesthesias. The symptoms are more pronounced during the night, while waking-up and after sudden head movements. Radiological changes mainly occur at C 4–C 7, but are not pathegnomonic. Hearing loss is rather frequent, usually one-sided and non fluctuating. The audiogram is not characteristic for its cervical origin. In 80% recruitment is present, tinnitus occurs in 30–60% of the patients, but displacusis and fullness of the ear do not occur. The vestibular symptomatology is the best differential diagnostic tool.