Investigation of suspected Guillain–Barre syndrome in childhood: What is the role for gadolinium enhanced magnetic resonance imaging of the spine?

Smith, Nicholas J.; Pereira, John; Grattan-Smith, Padraic J.

doi:10.1111/j.1440-1754.2010.01802.x

Cited by 11 publications

(13 citation statements)

References 36 publications

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“…Less-invasive techniques than lumbar puncture and NCS may be considered to confirm the diagnosis of GBS. Recently, gadolinium-enhanced magnetic resonance imaging of the nerve roots was reported to be equally accurate as NCS [13], and lumbar puncture [14]. MRI may be especially valuable in centers with limited pediatric neurophysiological expertise.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Guillain–Barré syndrome in children and validation of the Brighton criteria

Roodbol,

de Wit,

van den Berg

et al. 2017

J Neurol

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To describe the key diagnostic features of pediatric Guillain–Barré syndrome (GBS) and validate the Brighton criteria. Retrospective cohort study of all children (<18 years) diagnosed with GBS between 1987 and 2013 at Sophia Children’s Hospital, Erasmus MC, Rotterdam. Clinical information was collected and the sensitivity of the Brighton criteria was calculated. 67 children (35 boys) were included, with a median age of 5.0 years [interquartile range (IQR) 3.0–10.0 years]. Bilateral limb weakness was present at hospital admission in 93% of children, and at nadir in all patients. Children presented with tetraparesis in 70% or with paraparesis in 23%. Reduced reflexes in paretic limbs were observed at hospital admission in 82% and during follow-up in all children. The progressive phase lasted median 6 days (IQR 3–8 days) and less than 4 weeks in all children. A monophasic disease course was seen in 97%, including 5 children with a treatment-related fluctuation. Two children had a later relapse at 9 weeks and 19 weeks after onset. 77% of the children showed an elevated protein level in CSF. Nerve conduction studies showed evidence for a poly(radiculo)neuropathy in 91% of the children. 46 children had a complete data set, the sensitivity of the Brighton criteria level 1 was 72% (95% CI 57–84) and 96% (95% CI 85–99) for level 2 and 98% (95% CI 88–100) for level 3. The majority of the pediatric GBS patients presented in this cohort fulfilled the current diagnostic criteria.Electronic supplementary materialThe online version of this article (doi:10.1007/s00415-017-8429-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Diagnosis of Guillain–Barré syndrome in children and validation of the Brighton criteria

Roodbol,

de Wit,

van den Berg

et al. 2017

J Neurol

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“…Follow‐up of nerve imaging changes in GBS has been reported only with spinal MRI 2–4. In these reports, both in adult and pediatric patients, the disappearance of nerve enlargement paralleled clinical improvement, with normalization of nerve size when patients became asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

“…Spinal magnetic resonance imaging (MRI) has been demonstrated to have high sensitivity for diagnosis of GBS in adults and children, revealing nerve thickening and contrast enhancement of spinal roots in the cauda equina 2–5. MRI follow‐up studies show decreased nerve root enhancement as the patient improves clinically, and there is complete resolution within 6–12 months after onset 2–4…”

mentioning

confidence: 99%

Nerve ultrasound follow‐up in a child with Guillain‐Barré syndrome

et al. 2012

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“…Over the last 2 years, a handful of small case series have looked at positive imaging findings, which may be suggestive of GBS. The most often reported finding is greater enhancement of the anterior compared with posterior roots of the cauda equina, but other patterns of root and cranial nerve enhancement have also been reported (Smith et al ., ; Yikilmaz et al, ; Zuccoli et al ., ) . Whilst the sensitivity of some of these appearances may be high, the specificity is as yet undefined.…”

Section: Diagnosticsmentioning

confidence: 97%

Update on Guillain‐Barré syndrome

Rinaldi

2013

J Peripheral Nervous Sys

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Understanding of Guillain-Barré syndrome (GBS) has progressed substantially since the seminal 1916 report by Guillain et al. Although Guillain, Barré, and Strohl summarised the syndrome based on observations of two French infantrymen, 2012 saw the beginning of an ambitious collaborative study designed to collect detailed data from at least 1,000 patients worldwide (IGOS, www.gbsstudies.org/about-igos). Progress has been made in many areas even since GBS was last reviewed in this journal in 2009. GBS subsequently received prominent attention in light of concerns regarding H1N1 influenza vaccinations, and several large-scale surveillance studies resulted. Despite these developments, and promising pre-clinical studies, disease-modifying therapies for GBS have not substantially altered since intravenous immunoglobulin was introduced over 20 years ago. In other areas, management has improved. Antibiotic prophylaxis in ventilated patients reduces respiratory tract infection, thromboprophylaxis has reduced the risk of venous thromboembolism, and there is increasing awareness of the benefit of high-intensity rehabilitation. This article highlights some of the interesting and thought-provoking developments of the last 3 years, and is based on a plenary lecture given at the 2012 Peripheral Nerve Society (PNS) meeting.

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Investigation of suspected Guillain–Barre syndrome in childhood: What is the role for gadolinium enhanced magnetic resonance imaging of the spine?

Cited by 11 publications

References 36 publications

Diagnosis of Guillain–Barré syndrome in children and validation of the Brighton criteria

Diagnosis of Guillain–Barré syndrome in children and validation of the Brighton criteria

Nerve ultrasound follow‐up in a child with Guillain‐Barré syndrome

Update on Guillain‐Barré syndrome

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