Guillain-Barré Syndrome in a Patient With Cervical Myelopathy and Lumbar Spinal Stenosis Following a Fall: A Diagnostic Challenge.

Guillain-Barré syndrome (GBS) is an acute autoimmune disease characterized by symmetrical weakness that develops over a few days to four weeks. Its diagnosis can be challenging when symptoms overlap with other conditions, such as lumbar spinal stenosis. We report the case of a 55-year-old man who presented with sudden lower-extremity weakness and bladder incontinence following a fall after alcohol intake. Magnetic resonance imaging revealed cervical and lumbar spinal stenosis with compressive changes, which were initially considered the likely cause of his symptoms. However, the patient subsequently deteriorated, with investigations revealing positive results for Klebsiella and rhinovirus. Given the progression of his neurological deficits, GBS was suspected, and plasmapheresis was initiated. Cerebrospinal fluid (CSF) analysis demonstrated albuminocytologic dissociation, while nerve conduction studies (NCS) showed severe widespread sensorimotor axonal polyneuropathy, supporting the diagnosis. The patient showed significant neurological and functional improvement following treatment and rehabilitation. This case highlights the diagnostic challenges of differentiating GBS from cervical spondylotic myelopathy in patients with pre-existing spinal pathology. Precise history-taking, serial neurological examinations, and appropriate investigations, including CSF analysis and NCS, are essential to avoid misdiagnosis and facilitate early management and improved patient outcomes.