Chanderpaul, who averages more than 42 in Tests, made 101 runs in six innings in the series.
He is replaced by uncapped Antigua batsman Sylvester Joseph in the only change to the 13-man squad.
In a statement, the West Indies Cricket Board said they felt the left-handed Chanderpaul had looked "tired and lethargic" during the third test defeat in Barbados.
Reluctant to comply with a WICB request for him to be evaluated by the board's medical panel in Barbados, Chanderpaul "has therefore been allowed to return home for further evaluation," the statement said.
Joseph, 25, has played four one-day internationals and impressed with innings of 36 and 50 for the Carib Beer XI in their tour match against England before the third Test.
West Indies must avoid defeat in Antigua or suffer a first ever whitewash in a home test series.
England, who are likely to name the same starting XI for the fourth successive match, will confirm their line-up later in the week.
Squad:
Brian Lara (captain), Ramnaresh Sarwan, Chris Gayle, Daren Ganga, Ricardo Powell, Sylvester Joseph, Dwayne Smith, Ryan Hinds, Ridley Jacobs, Tino Best, Pedro Collins, Corey Collymore, Fidel Edwards.
