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Medical Emergencies · single question

A 74-year-old male is brought in by his daughter, who reports he has felt unwell since receiving a flu shot one week ago. He has no fever, but is showing progressive motor weakness. What is he most likely experiencing?

  1. Amyotrophic lateral sclerosis (ALS)
  2. Guillain-Barré syndrome (an acute, ascending autoimmune polyneuropathy, rarely triggered by a preceding infection or, very rarely, vaccination)
  3. A typical, expected vaccine side effect requiring no further workup
  4. A stroke
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Correct answer: B. Guillain-Barré syndrome (an acute, ascending autoimmune polyneuropathy, rarely triggered by a preceding infection or, very rarely, vaccination)

Guillain-Barré syndrome presents with acute or subacute, often ascending, motor weakness, and has a recognized (though rare) temporal association with a preceding trigger such as an infection (most classically Campylobacter jejuni) or, very rarely, vaccination, studied extensively in vaccine pharmacovigilance literature. ALS, in contrast, is a chronic, progressive, non-inflammatory neurodegenerative disease that wouldn't present acutely one week after a single triggering event.

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