A Missed Diagnosis of Guillain-Barre Syndrome Masquerading As Stroke in an Acute Medical Unit: A Case Report

Abstract

An elderly woman aged 66 presented to a general hospital with left-sided facial paresis, bilateral lower limb weakness, and back pain. After undergoing clinical assessments and investigations, she was diagnosed and treated as a case of acute stroke. Two weeks later, she was repatriated to our hospital for neuro-rehabilitation. Unconvinced, we revisited her clinical history and, after a thorough physical examination, made a clinical diagnosis of GuillainBarre Syndrome (GBS), i.e., confirmed by electrophysiological studies. She was treated with intravenous immunoglobulin and made a complete recovery 6 weeks later.

This case highlights an infrequent presentation of GBS as a stroke-mimic. It re-emphasizes the need to maintain a high index of clinical suspicion for similar expressions, especially in busy acute medical units. Such cases are easily missed if basic clinical skills, such as good historytaking and thorough physical examination, are glossed over. Despite time constraints, these skills are indispensable in clinical practice.