Co-morbid Guillain-Barré syndrome and acute disseminated encephalomyelitis

Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
Neurosciences (Impact Factor: 0.71). 04/2013; 18(2):166-8.
Source: PubMed


Guillain-Barre syndrome (GBS) and acute disseminated encephalomyelitis (ADEM) are clinically distinct demyelinating disorders that share an autoimmune pathogenesis and prior history of viral infection or vaccination. Concurrent GBS and ADEM are uncommon with few reported cases. Our patient is a 10-year-old girl who presented with acute quadriparesis, areflexia, and urinary retention. Lumber puncture revealed mild pleocytosis and elevated protein. She required mechanical ventilation and failed to improve after intravenous immunoglobulins. She subsequently developed double vision and disturbed level of consciousness. Brain MRI revealed multiple white matter lesions suggestive of ADEM. Based on the temporal association and exclusion of alternative etiologies, we made a diagnosis of GBS and ADEM. She improved remarkably after intravenous methylprednisolone. We conclude that co-morbid GBS and ADEM is an uncommon entity presenting with severe neurological morbidity. Prompt recognition and treatment can hasten the recovery and therefore improve the neurological outcome.

Download full-text


Available from: Mohammed M Jan
  • [Show abstract] [Hide abstract]
    ABSTRACT: Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis in children. This review discusses the heterogeneous presentations of this disorder, the frequency of disease-related complications and the importance of assiduous clinical care in pediatric GBS. Recent reports have highlighted the variable clinical and neurophysiologic subtypes of pediatric GBS, and emphasized the value of imaging in diagnosis of this disorder. Diagnosis of pediatric GBS is often delayed because of its variable presentation. Early recognition and treatment decrease long-term morbidity and mortality. Recent research has cast light on the variable presentations and pathogenesis of the numerous subtypes of this condition, and is now focusing upon a better understanding of the natural history of GBS.
    No preview · Article · Dec 2013 · Current opinion in pediatrics