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Simultaneous Guillain-Barré Syndrome and Acute Disseminated Encephalomyelitis in the Pediatric Population

Division of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University, Quebec, Canada, genevievebernard{at}hotmail.com

Émilie Riou, MD

Division of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University, Quebec, Canada

Bernard Rosenblatt, MD, FRCPC

Division of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University, Quebec, Canada

Marie-Emmanuelle Dilenge, MD, FRCPC

Division of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University, Quebec, Canada

Chantal Poulin, MD, FRCPC

Division of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University, Quebec, Canada

Few cases of simultaneous acute demyelination of the peripheral and central nervous systems are reported. Four patients diagnosed as having Guillain-Barré syndrome and acute disseminated encephalomyelitis during the same hospitalization are described herein. Two patients manifest an atypical form of Guillain-Barré syndrome, with magnetic resonance imaging of the head showing acute disseminated encephalomyelitis. A third patient has acute disseminated encephalomyelitis and develops Guillain-Barré syndrome during his hospitalization. A fourth patient demonstrates transverse myelitis that evolves into Guillain-Barré syndrome, with demyelination seen on brain magnetic resonance imaging. All patients are treated with intravenous immunoglobulins or corticosteroids. Three patients have a favorable outcome; 1 patient has a chronic inflammatory demyelinating polyradiculoneuropathy. Guillain-Barré syndrome and acute disseminated encephalomyelitis can occur simultaneously in the pediatric population. This may be explained by a shared epitope between peripheral and central nervous system myelin. Further research is necessary to better describe this entity and its prognosis.

Key Words: demyelination • Guillain-Barré syndrome • inflammatory demyelinating polyradiculoneuropathy • acute disseminated encephalomyelitis

This version was published on July 1, 2008

Journal of Child Neurology, Vol. 23, No. 7, 752-757 (2008)
DOI: 10.1177/0883073808314360


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