MISCELLANEOUS FACTS FROM ON EXAMINATION

Question 1

A 25-year-old male with Hodgkin’s lymphoma is admitted with a three day history of deteriorating ptosis, muscle weakness and difficulty in breathing.
Which of the following is the most likely diagnosis?
(Please select 1 option)

Hypokalaemia

Inflammatory polyneuropathy

Intermediate syndrome

Polymyositis

Answer 1

Inflammatory polyneuropathy

Classic Guillain-Barré syndrome (GBS) is an acute, ascending, and progressive neuropathy characterised by:
- Ascending weakness
- Paraesthesias and
- Hyporeflexia.
In severe cases muscle weakness may lead to respiratory failure. Severe labile autonomic dysfunction also may occur.
Maximal weakness typically occurs two weeks after the initial onset of symptoms but may evolve early and abruptly. Two thirds of patients have a history of gastrointestinal or respiratory infection from one to three weeks prior to the onset of weakness.
Lymphomas, particularly Hodgkin’s disease, pregnancy, surgery, and drugs can cause it.