Clinical Reasoning: A 71-year-old woman with subacute progressive distal weakness and paresthesia after vaccination

A 71-year-old woman presented to the emergency department complaining of weakness and a dull ache in her lower limbs and symptoms of ascending paresthesia and anesthesia, which had appeared initially in the toes, but by the time of presentation 7 days later had ascended symmetrically to the shins. By the time of admission, she had begun to describe symptoms of paresthesia in both hands. There were no other symptoms in the upper limbs, trunk, or face, and she denied any sphincter disturbance. One week before the onset of symptoms, the patient had received a flu vaccine. She denied recent fever, sore throat, or diarrhea. There was no history of relevant alcohol intake, exposure to toxins, or recent foreign travel.
Source: Neurology - Category: Neurology Authors: Tags: Vasculitis, Peripheral neuropathy, Guillain-Barre syndrome, EMG RESIDENT AND FELLOW SECTION Source Type: research