IMAGES IN EMERGENCY MEDICINE
Winged scapula as the presenting symptom of Guillain–Barré syndrome
Leeds Teaching Hospitals NHS Trust, Leeds, UK
Correspondence to:
Correspondence to Dr M Sivan, Department of Rehabilitation Medicine, Chapel Allerton Hospital, Leeds, UK; drmanojsivan@yahoo.com
Accepted 2 October 2008
| The first 150 words of the full text of this article appear below. |
An 18-year-old British girl with long-standing traumatic winging of the scapula on the right side (from a sports injury) noticed spontaneous winging of the scapula on the left side with no other associated symptoms. The following day she developed left upper limb weakness, which then progressed to weakness of her other limbs. Her weakness was more pronounced in the upper limbs. All limbs were more weak proximally than distally. Cerebrospinal fluid analysis showed raised protein (0.5 g/l) and electrophysiological studies showed findings (absent F waves) consistent with Guillain–Barré syndrome. She was treated with 5 days of intravenous immunoglobulins and an extensive physiotherapy programme. She made a full recovery in 8 weeks with complete resolution of the winging of the scapula on the left side. Physicians must be aware that Guillain–Barré syndrome can rarely present with winging of the scapula as the first symptom/sign.
Figure 1 The photograph taken during the rehabilitation phase | |||||||||
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