Abstract 077: Bilateral medial medullary infarction mimicking Guillain‐Barré Syndrome (GBS): Case report and qualitative systematic review
Bibliographic record
Abstract
Purpose To summarize the medical literature related to the diagnosis of bilateral medial medullary infarction (MMI) mimicking GBS. Methods We identified all published case studies in five databases until February 2024. We performed a narrative synthesis to develop differential criteria on the included cases. A case report is also presented. Results We present the case of a patient with asymmetric and progressive motor weakness, bulbar dysfunction, albuminocytologic dissociation in cerebrospinal fluid (CSF), and negative brain CT scan in the acute stage. He was initially diagnosed with Guillain‐Barré Syndrome (GBS), treated with immunoglobulin without a favorable response, finally the diagnosis of MMI was made with re‐evaluation during the evolution and confirmed by brain magnetic resonance imaging. A systematic review of the literature of MMI case reports was carried out, focusing on an initial diagnosis of Guillain‐Barré Syndrome. We selected 8 studies (9 patients) of bilateral MMI with problems in the timely diagnosis and initial diagnosis of GBS. The most frequent clinical onset was respiratory problems (44.4%). The finding in CSF and nerve conduction studies were normal or negative in 60% of the cases. The delay occurred in the early stages of diagnosis in all cases. The use of immunosuppressive therapy was given in only one case. A discussion of the case report and the diagnostic challenges reported in the literature was made. Conclusion It is recommended to consider MMI for differential diagnosis in patients with symptoms of acute progressive quadriparesis and bulbar dysfunction, therefore a thorough assessment of the clinical presentation is necessary.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".