Upon admission, the patient exhibited various clinical findings. The examination revealed a body temperature of 38.5°C, a pulse rate of 152 beats per minute, a respiratory rate of 20 breaths per minute, and a blood pressure reading of 169⁄119 mmHg. No abnormal heart murmurs were detected upon auscultation in the different valve areas of the heart, and lung examination yielded no abnormalities. Neurologically, the patient displayed confusion, grade 0 muscle strength in all four limbs, decreased muscle tone, and absent tendon reflexes. Moreover, both pathological signs and meningeal irritation signs were absent. However, the patient demonstrated uncooperativeness during subsequent neurological examinations.
Combining these clinical observations with laboratory test results (as shown in Table 1), Guillain-Barré syndrome was suspected as a potential diagnosis due to its association with an infectious onset, progressive course of symptoms, symmetrical sensory and motor abnormalities, and loss of tendon reflexes.
Following admission, the patient received immunoglobulin (IVIG) therapy at a dose of 0.4g/kg/day for 5 days starting from the second day. Unfortunately, no significant improvement was noted in terms of limb numbness, weakness, or respiratory failure symptoms. To address these issues comprehensively, additional therapeutic measures were implemented including assisted ventilation using a ventilator, placement of an inferior vena cava filter to prevent emboli formation,disease prophylaxis measures to prevent infections ,anti-coagulation therapy,to correct electrolyte imbalances,sedative administration for comfort management,optimal control interventions targeting heart rate reduction,blood pressure elevation,and dehydration to reduce intracranial pressure along with medications aimed at enhancing gastrointestinal function.
Subsequent lumbar punctures were performed on October 18th and November 2nd to gather more information about the patient’s condition (refer to Table 1 for specific results).
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