Clinical Case Database / Category: Case Based Discussion
Guillian Barre Syndrome
Madiha Shahid MBBS, Michael Vassallo FRCP (London) FRCP (Edin) M.Phil PhD (Soton)
Foundation Years Journal, volume 1, issue 6, p.22 (123Doc Education, London, October 2007)
You are a Foundation year 1 doctor on call in the Emergency Department. You see a 63 year old man, normally fit and well and returned from Sicily after a months holiday. He was fine until a week later, when he developed sudden onset explosive diarrhoea 5-6 times a day. This was associated with bilateral leg weakness leading to reduced mobility. Stool cultures were positive for Campylobactre jejuni. Over a week his diarrhoea continued, weakness progressed, was unable to walk and soon went into urinary retention, for which he was catheterised. He had no sensory symptoms.
He now presented two weeks later, as being unable to move his hands and off legs completely since the previous afternoon. He had no further episodes of diarrhoea in the last 30 hours. His wife, who was with him on holiday remained well.
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Madiha Shahid MBBS
Foundation Year 1 Doctor
The Royal Bournemouth Hospital
Michael Vassallo FRCP (London) FRCP (Edin) M.Phil PhD (Soton) (Corresponding author)
The Royal Bournemouth Hospital
Castle Lane East
3. Macleodâs clinical examination, accessed in August 2007
4. J Neurol Neurosurg Psychiatry (JNNP), Micturational disturbances in patients with Guillain-Barre syndrome. Ryuji Skakibara, http://jnnp.bmj.com/cgi/content/abstract/63/5/649, accessed in August 2007
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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