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Anesthesiology Research and Practice
Volume 2008, Article ID 134958, 3 pages
Case Report

Acute Inflammatory Demyelinating Polyneuropathy and a Unilateral Babinski/Plantar Reflex

1Department of Surgery, University of Pisa, Pisa 56126, Italy
2Department of Anesthesiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
3Kings College Hospital, London SE5 9RS, UK
4Charing Cross Hospital, Hammersmith Hospitals NHS Trust, London W6 8RF, UK

Received 27 June 2007; Revised 20 August 2007; Accepted 29 September 2007

Academic Editor: Sabine Maria Sator-katzenschlager

Copyright © 2008 Davide Cattano et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Acquired acute demyelinating peripheral polyneuropathy (AADP) is a general classification of pathologies that could affect secondary the peripheral nervous system. They are characterized by an autoimmune process directed towards myelin. Clinically they are characterized by progressive weakness and mild sensory changes. Acute inflammatory demyelinating polyneuropathy often is referred to as Guillain-Barré syndrome (GBS). GBS is the major cause of acute nontraumatic paralysis in healthy people and it is caused by autoimmune response to viral agents (influenza, coxsackie, Epstein-Barr virus, or cytomegalovirus) or bacterial infective organisms (Campylobacter jejuni, Mycoplasma pneumoniae). A detailed history, with symptoms of progressive usually bilateral weakness, hyporeflexia, with a typical demyelinating EMG pattern supports the diagnosis. Progressive affection of respiratory muscles and autonomic instability coupled with a protracted and unpredictable recovery normally results in the need for ICU management. We present a case report of a patient with a typical GBS presentation but with a unilateral upgoing plantar reflex (Babinski sign). A unifying diagnosis was made and based on a literature search in Pubmed appears to be the first described case of its kind.