Question

A 29-year-old woman presents to the emergency room by ambulance in a wheelchair. She was brought from home with a complaint of rapidly progressive bilateral leg weakness over the past 2 weeks. Her legs were also painful and she complained of numbness and tingling in the lower part of both legs. Just prior to the onset of symptoms she had a 3-day bout of bad diarrhea with fever and chills that resolved spontaneously. Which one of the following would not be a likely finding on diagnostic testing and examination of this patient?

A. Diminished deep tendon reflexes
B. High cell count with absent protein in CSF
C. Conduction block and prolonged F-wave latencies on nerve conduction studies
D. Positive Campylobacter jejuni antibody serology
E. Complement-fixing antibodies to peripheral nerve myelin on nerve biopsy

Answer 1

One finding that would not be likely on diagnostic testing and examination of this patient with rapidly progressive bilateral leg weakness and other symptoms of Guillain-Barré syndrome is high cell count with absent protein in CSF.

Step-by-step explanation:

In this scenario, the patient's symptoms and history are suggestive of Guillain-Barré syndrome (GBS). GBS is characterized by rapidly progressive bilateral leg weakness, pain, and numbness. Additionally, GBS can be preceded by a bacterial infection, such as Campylobacter jejuni, which can be confirmed by positive Campylobacter jejuni antibody serology.

However, one finding that would not be likely on diagnostic testing and examination of this patient is B. High cell count with absent protein in CSF. In GBS, the cerebrospinal fluid (CSF) may show increased protein levels (albuminocytological dissociation), but the cell count is typically normal.

Other findings consistent with GBS include diminished deep tendon reflexes, conduction block and prolonged F-wave latencies on nerve conduction studies, and complement-fixing antibodies to peripheral nerve myelin on nerve biopsy.