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An uncommon cause of lower limb weakness
G Berlot1, M Viviani, R Bussani
1University of Trieste, Department of Anesthesia and Intensive Care, Cattinara Hospital, 34100, Trieste, Italy. berlot@univ.trieste.it
Intensive Care Medicine
|February 9, 2000
Summary
A patient with severe intellectual disability initially diagnosed with Guillain-Barré syndrome showed cardiovascular collapse. Further tests revealed heavy metal poisoning from ingested items, not Guillain-Barré syndrome.
Area of Science:
- Neurology
- Toxicology
- Internal Medicine
Background:
- Guillain-Barré syndrome is an autoimmune disorder affecting the peripheral nervous system.
- Plasma exchange is a recognized treatment for Guillain-Barré syndrome.
- Severe intellectual disability can complicate diagnosis and treatment.
Observation:
- A patient with severe intellectual disability presented with symptoms suggestive of Guillain-Barré syndrome.
- The patient underwent repeated plasma exchange for the presumed diagnosis.
- Abrupt cardiovascular collapse occurred during treatment, necessitating further investigation.
Findings:
- Neurologic symptoms were ultimately attributed to heavy metal poisoning.
- Ingestion of a large quantity of coins and metallic objects was identified as the cause.
- The initial diagnosis of Guillain-Barré syndrome was revised.
Implications:
- Highlights the importance of comprehensive diagnostic workup in complex cases.
- Underscores the need to consider environmental and ingestive factors in neurological presentations.
- Emphasizes the potential for misdiagnosis when underlying conditions are not fully elucidated.