Bibliographic record
Abstract
Secondary intracranial hypertension is a rare complication of Guillain-Barré syndrome (GBS).We describe a case with clinical, and neurophysiological evidence of GBS with headache and progressive bilateral vision loss 3 weeks after the onset of weakness.Fundoscopic examination showed bilateral papilledema with retinal hemorrhages.She had features of secondary intracranial hypertension, and required ventriculoperitoneal (VP) shunt.Our case emphasized that headache and vision changes in the setting of GBS should require detailed ophthalmology assessment, adequate monitoring, and treatment as indicated.A 33-year-old severely obese female without any past medical history presented with a 5-day history of progressive ascending weakness involving all limbs.Her weakness was preceded by an upper respiratory infection 2 weeks before presentation.There was no evidence of dysautonomia.She did not report vision changes on presentation.Cranial nerve examination revealed normal fundi, but dysarthric speech, along with bilateral lower motor neuron facial weakness, weak gag reflex, and weak tongue movements.Motor examination revealed flaccid tone in all limbs.Muscle strength was 3/5 proximally and 1-2/5 distally of all limbs using the Medical Research Council scale.Deep tendon reflexes were absent and plantar response was flexor bilaterally.Sensory examination revealed symmetrical glove/stocking sensory loss to wrist and knee level, respectively.CSF analysis revealed cytoalbuminologic dissociation with white blood cell (WBC) of 3 × 10 6 /L, and protein at 132 mg/dl.Human immunodeficiency virus test, and hepatitis B antigen were negative, and thyroid-stimulating hormones and T3/T4, antinuclear antibody, and extractable nuclear antigen antibodies were normal.Serum electrophoresis was unremarkable.She was immunized for rubella and measles in childhood.She did not have recent immunizations.Nerve conduction studies showed acquired demyelinating features with prolonged distal motor latencies at both upper and lower extremities, conduction blocks, absent F waves, and absent sensory nerve action potentials at median, ulnar, peroneal, and sural nerves.She was diagnosed with acute inflammatory demyelinating polyradiculoneuropathy, and started with intravenous immunoglobulin (IVIg) at the dose of 0.4g/kg daily for 5 days.After 2 weeks in hospital, she started to complain of increasing headache and vision changes.Examination revealed no meningsmus, but bilateral upgaze restriction and limited abduction with extraocular movements.Fundoscopic examination showed grade IV papilledema bilaterally with hemorrhages.Head CT scan and brain MRI with MR venography (MRV) were normal.Repeated lumbar puncture (LP) showed a high opening pressure greater than 500 mm H 2 O, protein of 143 mg/dl, and WBC of 2 × 10 6 /l.A total of 30 ml of CSF was removed.She reported symptomatic improvement.Idiopathic intracranial hypertension (IIH) was DISCLOSUREAA and FB have nothing to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.008 | 0.004 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".