Guillain-Barre Syndrome Mimicked by Spinal Stenosis in A Case of Chronic Prolapsed Intervertebral Disc: A Case Report




Guillain-Barre Syndrome, Polyradiculoneuropathy, Intervertebral Disc Displacement, Spinal Stenosis


Background: Guillain-Barre Syndrome (GBS) is a rare acute autoimmune polyneuropathy, usually preceded by infections. It can be difficult to diagnose, especially in patients with underlying neurological comorbidities.

Case: A 54-year-old male, with a long history of a prolapsed intervertebral disc, presented with progressive and asymmetrical onset tetraparesthesia for 4 weeks, which was associated with progressive paraparesis for 2 weeks. The diagnosis of GBS was initially missed due to a lack of relevant history of prior infection, atypical presentation (asymmetrical limb weakness), and radiological evidence of spinal stenosis. Nerve conduction study, cerebrospinal fluid analysis, and antiganglioside antibodies later confirmed the diagnosis of GBS. The patient was started on intravenous immunoglobulin and achieved significant improvement. He was discharged a week later and transferred to a rehabilitation hospital.

Conclusion: GBS should not be excluded prior to diagnostic tests and lab work in neurological patients. Physicians should avoid over-reliance on radiological findings to conclude a diagnosis. Comprehensive history and examinations to understand the development of patients' presentations should be prioritized when establishing a diagnosis.


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Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, Abbasi-Kangevari M, Abbastabar H, Abd-Allah F, Abdelalim A, Abdollahi M. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-22. DOI:

Willison HJ, Jacobs BC, Doorn PA van. Guillain-Barré syndrome. Lancet. 2016;388(10045):717–27. DOI:

Bragazzi NL, Kolahi AA, Nejadghaderi SA, Lochner P, Brigo F, Naldi A, et al. Global, regional, and national burden of Guillain–Barré syndrome and its underlying causes from 1990 to 2019. J Neuroinflammation. 2021;18(1):264. DOI:

Piccione EA, Salame K, Katirji B. Guillain-Barré Syndrome and Related Disorders. In: Katirji B, Kaminski HJ, Ruff RL (eds.) Neuromuscular Disorders in Clinical Practice. Springer, New York; 2014. p. 573–603. DOI:

Alvarez JA, Hardy RH. Lumbar spine stenosis: a common cause of back and leg pain. Am Fam Physician. 1998;57(8):1825–34, 1839–40.

Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA. 2022;327(17):1688–99. DOI:

Leonhard SE, Mandarakas MR, Gondim FAA, Bateman K, Ferreira MLB, Cornblath DR, et al. Diagnosis and management of Guillain–Barré syndrome in ten steps. Nat Rev Neurol. 2019;15(11):671–83. DOI:

van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs BC, van Doorn PA. Guillain–Barré syndrome: pathogenesis, diagnosis, treatment and prognosis. Nat Rev Neurol. 2014;10(8):469–82. DOI:

Asbury AK, Cornblath DR. Assessment of current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol. 1990;27(S1):S21–4. DOI:

Fokke C, van den Berg B, Drenthen J, Walgaard C, van Doorn PA, Jacobs BC. Diagnosis of Guillain-Barré syndrome and validation of Brighton criteria. Brain. 2014;137(1):33–43. DOI:

Sejvar JJ, Kohl KS, Gidudu J, Amato A, Bakshi N, Baxter R, et al. Guillain-Barré syndrome and Fisher syndrome: case definitions and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine. 2011;29(3):599–612. DOI:

Finley CR, Chan DS, Garrison S, Korownyk C, Kolber MR, Campbell S, Eurich DT, Lindblad AJ, Vandermeer B, Allan GM. What are the most common conditions in primary care? Systematic review. Can Fam Physician. 2018;64(11):832-840.

Walgaard C, Lingsma HF, Ruts L, van Doorn PA, Steyerberg EW, Jacobs BC. Early recognition of poor prognosis in Guillain-Barre syndrome. Neurology. 2011;76(11):968-75. DOI:

Doets AY, Lingsma HF, Walgaard C, Islam B, Papri N, Davidson A, et al. Predicting Outcome in Guillain-Barré Syndrome: International Validation of the Modified Erasmus GBS Outcome Score. Neurology. 2022;98(5):e518-e532.

Walgaard C, Jacobs BC, Lingsma HF, Steyerberg EW, van den Berg B, Doets AY, et al. Second intravenous immunoglobulin dose in patients with Guillain-Barré syndrome with poor prognosis (SID-GBS): a double-blind, randomised, placebo-controlled trial. Lancet Neurol. 2021;20(4):275-283. DOI:

Jacobs BC, van den Berg B, Verboon C, Chavada G, Cornblath DR, Gorson KC, et al. International Guillain-Barré Syndrome Outcome Study: protocol of a prospective observational cohort study on clinical and biological predictors of disease course and outcome in Guillain-Barré syndrome. J Peripher Nerv Syst. 2017;22(2):68-76. DOI:


2023-02-21 — Updated on 2023-06-30

How to Cite

Lee, Y. X. (2023). Guillain-Barre Syndrome Mimicked by Spinal Stenosis in A Case of Chronic Prolapsed Intervertebral Disc: A Case Report. International Journal of Medical Students, 11(2), 134–138.



Case Report