Concurrency of Guillain-Barre syndrome and acute transverse myelitis: a case report and review of literature / 소아과

Guillain-Barré syndrome and acute transverse myelitis manifest as demyelinating diseases of the peripheral and central nervous system. Concurrency of these two disorders is rarely documented in literature. A 4-year-old girl presenting with cough, fever, and an impaired walking ability was admitted to hospital. She had no previous complaints in her medical history. A physical examination revealed lack of muscle strength of the lower extremities and deep tendon reflexes. MRI could not be carried out due to technical problems; therefore, both Guillain-Barré syndrome and acute transverse myelitis were considered for the diagnosis. Intravenous immunoglobulin treatment was started as first line therapy. Because this treatment did not relieve the patient's symptoms, spinal MRI was carried out on the fourth day of admission and demyelinating areas were identified. Based on the new findings, the patient was diagnosed with acute transverse myelitis, and high dose intravenous methylprednisolone therapy was started. Electromyography findings were consistent with acute polyneuropathy affecting both motor and sensory fibers. Therefore, the patient was diagnosed with concurrency of Guillain-Barré syndrome and acute transverse myelitis. Interestingly, while concurrency of these 2 disorders is rare, this association has been demonstrated in various recent publications. Progress in diagnostic tests (magnetic resonance imaging and electrophysiological examination studies) has enabled clinicians to establish the right diagnosis. The possibility of concurrent Guillain-Barré syndrome and acute transverse myelitis should be considered if recovery takes longer than anticipated.

Who presents to our electroneurophysiology laboratory?

To determine the distribution rate of Electroneuromyography diagnosis and correspondence between the preliminary diagnosis and final outcome. The retrospective study was conducted at the Department of Neurology, Harran University, Sanliurfa, Turkey, and comprised record of patients diagnosed with Electroneuromyography during a 24-month period from April 2011 to April 2013. SPSS 11.5 was used for data analysis. Of the 4,230 cases reviewed, 1,946 [46%] showed normal Electroneuromyography findings despite pathological Electroneuromyography findings in 2,284[54%] cases. The most common diagnosis was carpal tunnel syndrome in 721[17%] patients, followed by polyneuropathy 312[7.4%], peripheral nerve injury 238[5.6%], brachial plexus lesion 180[4.3%], myopathy 114[2.7%], lumbar radiculopathy 108[2.6%], poliomyelitis 62[1.5%] and injection neuropathy 62[1.5%]. Off-label use of Electroneuromyography may be reduced by using electroneurophysiological laboratory rotation as well as adequate and comprehensive clinical evaluation of patients