Rare Sensory Ataxic Variant of Guillain-Barre Syndrome: A Case Report.

The sensory ataxic variant of Guillain-Barre syndrome (GBS) is a rare subtype, with limited case reports available. We present the case of a previously healthy 26-year-old female university student who presented with bilateral foot numbness and unsteady gait for five days, without limb weakness. There were no signs of infection or recent history suggestive of infection. Examination revealed reduced pain and light touch sensation, as well as proprioception impairment in the bilateral distal lower limb, accompanied by an ataxic gait. Bilateral upper and lower limb power was normal. Cerebrospinal fluid (CSF) studies showed albuminocytological dissociation, while nerve conduction studies indicated unrecordable sensory responses with normal motor responses. Through a comprehensive evaluation of history, examination, and investigations, other potential differential diagnoses were excluded. Then the patient was diagnosed with a sensory ataxic variant of Guillain-Barre syndrome and treated with intravenous immunoglobulin (IVIG). Over time, the patient demonstrated gradual improvement and was able to resume her university studies four months after discharge.

Effect of time of admission on compliance with deep vein thrombosis prophylaxis in a tertiary medical intensive care unit.

OBJECTIVE: We sought to evaluate deep vein thrombosis (DVT) prophylaxis compliance according to time of admission in a medical intensive care unit (MICU). METHODS: This was a retrospective cohort study at a closed tertiary MICU. We classified patients into three groups (week days, weekends, and week nights), according to time of admission. An unweighted risk factor score (RFS) was calculated from 20 known risk factors. We defined DVT prophylaxis compliance as any type of prophylaxis (mechanical or pharmacologic) for RFS 3. Non-compliance was defined as no prophylaxis or single-type prophylaxis for RFS > 3. RESULTS: We analyzed 105 admissions. Eighty (76.19%) patients received compliant DVT prophylaxis, and 25 (23.81%) patients received non-compliant regimens of whom 11 (10.48%) were not on any prophylaxis. DVT prophylaxis compliance was not different across the three admission groups. The non-compliant DVT prophylaxis group had a higher RFS (3.48 +/- 2.1 vs. 2.25 +/- 1.5; P = 0.011), a trend towards fewer female patients (40% vs. 60%; P = 0.079), and a higher percentage of admissions by interns at the first postgraduate year (PGY) level (28% vs. 5.4%; P = 0.01). Logistic regression revealed that only RFS and PGY level were independent predictors for compliance (P = 0.015 and 0.005 respectively). Time of admission was not a significant factor. CONCLUSIONS: Time of admission did not influence DVT prophylaxis compliance. Compliance improved with higher PGY level and lower RFS. A higher level of knowledge probably explains the association with PGY level; however, we cannot explain the inverse relationship between RFS and compliance.

Extensive radiculopathy: a manifestation of intracranial hypertension.

We report two patients with severe radiculopathy due to elevated intracranial pressure (ICP) resulting from idiopathic intracranial hypertension (IHH) in one, and cerebral venous sinus thrombosis (CVT) in the other. Our aim is to document this unique association, which escaped diagnosis in both patients.