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KMID : 1040020150060010042
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International Journal of Pain
2015 Volume.6 No. 1 p.42 ~ p.48
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Contrast-enhanced MRI Confirms Undiagnosed Guillain-Barre Syndrome with Severe Bilateral Lower Extremity Pain: A Case Report
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Park Jung-Min
Yun So
Lee Pil-Moo
Kim Ka-Ram
Kim Jae-Hun
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Abstract
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Guillain-Barre syndrome (GBS) is an autoimmune disease characterized as acute and progressive, and inflammatory demyelinating polyneuropathy. It is usually diagnosed on the basis of previous infection history, symptoms and signs accompanied with CSF study and neurophysiological examination. We report on a 44-year-old woman with Guillain-Barre syndrome (GBS) who presented a chief complaint of pain in the extremities, which was followed by progressive lower extremity weakness. The patient had no previous infection history which is typical with GBS. MRI scans without contrast enhancement at a local clinic revealed only disc degeneration on L5-S1 without any pathologic lesion found. Her symptoms improved somewhat after a second set of epidural steroid injections. However, her lower extremity weakness progressed, so she was transferred to our pain clinic. After checking nerve conduction studies and another contrast-enhanced MRI that revealed marked enhancement of the nerve roots in the cauda equine on T1-weighted imaging, the patient was diagnosed with GBS.
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KEYWORD
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Guillain-Barre syndrome, lower extremity pain, MRI, polyneuropathy, radiculopathy, weakness
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