Presentation
Ascending paralysis after upper respiratory tract infection
Patient Data
Evidence of thickening and abnormal enhancement of the ventral nerve roots of cauda equina, suggestive of Guillain Barre syndrome.
No evidence of mass lesion or disc herniation. Normal vertebral body height and alignment.
Blooming artifact is seen at the pelvis of the right kidney.
CSF microscopy:
Protein: 135.2 mg/dL, Glucose: 69 mg/dL, RBCs 0, WBCs 0
Case Discussion
Guillain-Barré syndrome (GBS) is the most common cause of rapidly progressive flaccid paralysis.
Most cases are preceded by upper respiratory tract infections or diarrhea one to three weeks before their onset.
CSF analysis showing increased protein without pleocytosis (also known as albuminocytologic dissociation).
On imaging, there's thickening and contrast enhancement of the nerve roots of the cauda equina, mainly the anterior nerve roots.
The cranial nerves are affected in 30-40% of cases.
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