Bilateral Lower Extremity Weakness: Spinal Epidural Lipomatosis or more?

Spinal epidural lipomatosis is a condition that is characterized by an excess amount of epidural adipose tissue in the spinal canal. Occasionally, it can narrow the spinal canal enough to cause cord impingement resulting in neurological deficits. The authors report on a case of a 43-year-old man who presented to the emergency department with bilateral lower extremity weakness. After computed tomography imaging, he was found to have spinal lipomatosis. Since the patient had other symptoms that could not be accounted for by this diagnosis alone, he was admitted to the hospital for further neurologic workup. He eventually developed ascending areflexia which led to the diagnosis of Guillain-Barré, which was corroborated by further history that was not available initially.