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Area of Science:

  • Neurology
  • Neurophysiology

Background:

  • Guillain-Barré Syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system.
  • Spinal cord infarction is a rare but serious condition causing acute neurological deficits.

Purpose of the Study:

  • To present a unique case where spinal cord infarction was initially misdiagnosed as GBS.
  • To analyze the role of F wave abnormalities in nerve conduction studies/electromyography (NCS/EMG) in diagnosing central nervous system lesions.

Main Methods:

  • Clinical presentation of a 42-year-old female with acute lower extremity weakness and urinary incontinence.
  • Initial negative spine MRI, followed by NCS/EMG revealing abnormal F waves.
  • Treatment with plasmapheresis for suspected GBS without improvement.
  • Repeat spine MRI confirming extensive spinal cord infarction.

Main Results:

  • NCS/EMG showed absent F waves in fibular nerves and abnormal F waves in tibial nerves.
  • Plasmapheresis for presumed GBS was ineffective.
  • Spine MRI ultimately revealed lower thoracic and lumbar spinal cord infarction.

Conclusions:

  • F wave abnormalities can be influenced by acute central nervous system lesions, complicating peripheral nerve study interpretations.
  • This case underscores the importance of considering spinal cord infarction in the differential diagnosis of acute myelopathy, even with initial atypical findings.