CSF examination in a 28-year-old man with ascending weakness shows protein of 180 mg/dL with only 3 cells per microliter. This pattern, termed albuminocytological dissociation, indicates:
- A Impaired glucose transport into CSF with intact cellular barrier
- B Overproduction of protein by the choroid plexus
- C Disrupted blood-nerve barrier at inflamed nerve roots without significant inflammation within the subarachnoid space ✓
- D Obstruction of CSF flow at the foramen magnum
Correct answer: C. Disrupted blood-nerve barrier at inflamed nerve roots without significant inflammation within the subarachnoid space
Explanation
In Guillain-Barre syndrome, inflammatory demyelination of spinal nerve roots disrupts the local blood-nerve barrier, allowing protein to leak into CSF while the meninges remain free of cellular inflammation, giving high protein with a near-normal cell count. Choroid plexus protein production does not rise in disease, and complete CSF obstruction produces Froin syndrome with very high protein plus xanthochromia and coagulation, features absent here.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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