83 y.o. female with relevant past medical history of hypertension, hyperlipidemia and hypothyroidism presented to an OSH on 12/26 with complaint of significant lower extremity weakness. Pt was found to have AIDP, acute respiratory failure (extubated 1/5), and acute toxic metabolic encephalopathy, now s/p plasmapheresis (completed on 1/15) and cryoprecipitate (1/16) now presenting with incomplete tetraplegia with LE much more affected than UE. Admitted to for AIDP on 1/17/2025. AIDP -consistent with GBS, especially given elevated CSF protein, absent DTRs and recent influenza and COVID vaccines about 1 month ago -CSF studies to date reviewed: -Protein 124.6, glucose 101 -Lactic acid 2.2 -WBC 1, RBC 1 -Gram stain no organisms, Cx NGTD -VDRL not detected -VZV, HSV, CMV, WNV, enterovirus PCR negative -KOH prep reveals no mycelia or yeast forms; ABF smear negative -Cytology revealed increased white cells with a few neutrophils, lymphocytes and many monocytes -Completed 5 sessions of plasmapheresis last on 1/15.