BOF 8

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BOF: 8

A 40-year-old male presents with a history of rapidly progressive weakness of his legs of 4 days duration. He gives a history of gastroenteritis about 3 weeks prior to this. He has been otherwise fit and healthy. He does not smoke or drink and does not take any medication.

On examination he has a flaccid weakness of his lower limbs with absent reflexes. There is impairment of sensation upto his thighs.

Investigations reveal normal haematology and biochemistry. Lumbar puncture is performed and this shows:

Pressure 16 mm CSF

CSF protein 3.4 g/dL

CSF glucose 4 mmol /L

Leucocytes 5/mL

Gram stain – no organisms

Plasma glucose 4.5 mmol/L

In this patient which one of the following would give the patient the most benefit:

a)      High dose steroids

b)      Intravenous immunoglobulin

c)      Intravenous acyclovir

d)      Pyridostigmine

e)      Beta interferon

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