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Not the Guillain–Barré Syndrome

Division of Neurology, Department of Neurosciences, University of the Witwatersand, Johannesburg, South Africa; Email: connorm{at}chiron.wits.ac.za

EXTRACT

Taking over a colleague’s patient is not easy. The handover time is fraught with potential pitfalls, particularly if the clinician is inexperienced. As a neurology trainee I was involved in the management, or rather mismanagement, of a patient and learned to be vigilant at the time of handover, particularly when things do not seem to be quite what they should be.

THE STORY

The patient, a 69-year-old woman, was to be transferred to a rehabilitation facility the day I joined the unit. The diagnosis of Guillain–Barré syndrome was based on clinical features and albumino-cytological dissociation in the cerebrospinal fluid. The hospital’s neurophysiologist was on leave and the senior trainee had performed the nerve conduction study. He felt the findings were compatible with an acute demyelinating and axonal polyneuropathy. The patient had received intravenous immunoglobulin and, over the week prior to discharge, with the physiotherapist’s help she had made a ...

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