Question

Assertion (A): Lumbar puncture is indicated in a child with fever and asymmetric flaccid limb weakness.

Reason (R): The diagnosis of Guillain-Barre syndrome can be established by albuminocytologic dissociation on CSF analysis.

• A. Both A and R are true and R is the correct explanation of A.
• B. Both A and R are true but R is NOT the correct explanation of A.
• C. A is true but R is false.
• D. A is false but R is true.

Hint:

Compare the classic pattern of polio with the classic pattern of Guillain-Barre syndrome.

Answer 1

The Correct Option is B

Step 1: Understand the assertion.
A child presenting with fever and sudden flaccid (floppy) weakness that is asymmetric, meaning it affects one side or one limb more than the other, needs urgent evaluation to tell apart the causes of acute flaccid paralysis. Lumbar puncture, to look at the cerebrospinal fluid (CSF), is a key part of that evaluation, since different causes leave different CSF patterns. So the assertion, that lumbar puncture is indicated here, is true.

Step 2: Understand the reason.
Guillain-Barre syndrome (GBS) is an immune-mediated nerve disorder that classically causes symmetric, ascending flaccid weakness, usually without fever. Its CSF shows albuminocytologic dissociation, meaning the protein level is raised while the white cell count stays normal or only mildly raised. As a stand-alone fact about how GBS is diagnosed, this statement is true.

Step 3: Check if the reason explains the assertion.
The child described here has fever and asymmetric weakness, which points more toward acute paralytic poliomyelitis than toward GBS, since polio typically causes fever with asymmetric weakness and a CSF pattern of raised cells (pleocytosis) rather than albuminocytologic dissociation. The lumbar puncture is done in this case to help separate polio from other causes of flaccid paralysis, not specifically because the child is thought to have GBS. So while R is a true fact about GBS diagnosis, it is not the reason the lumbar puncture is being done in this particular, febrile and asymmetric, presentation.

Step 4: Rule out the other options.
Option (a) fails because the connection between A and R is not correct for this presentation. Option (c) fails because R is a true statement about GBS. Option (d) fails because A is true, lumbar puncture is indeed indicated to work up this child.

Final Answer:
Both A and R are true but R is NOT the correct explanation of A.