Paradigm Shift to Spinal Magnetic Resonance Imaging the Diagnosis of Guillain-Barre Syndrome in Children
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Purpose: This study was aimed to evaluate the clinical value of gadolinium-enhanced spinal magnetic resonance imaging (MRI) in the diagnosis of Guillain-Barre syndrome (GBS) by comparing it with cerebrospinal fluid (CSF) and nerve conduction studies (NCS) in children. Method: A single center, retrospective analysis of clinical investigations undertaken in children with GBS over a 5-year period was performed. The patients’ respective medical records, including spinal MRIs and nerve conduction studies, were reviewed. Results: A total of seventeen children (mean age 5.3±3.6 years; males, 12, females, 5) were enrolled in the study. Twelve out of 17 children (71%) showed gadolinium nerve root enhancement, mostly anterior along with posterior roots (10/12, 83%) at 4.1 days of illness, compared to CSF (2/11, 11%) at 2.5 days and NCS (11/17, 64%) at 7.4 days of illness (P<0.05). In addition, it appeared the more severe symptoms showed more positive findings; however, the difference was statistically insignificant (P>0.05). Conclusion: In conclusion, NCS are a standard diagnostic tool for GBS. This study supports the gadolinium-enhanced spinal MRI as a valuable investigating technique in the early diagnosis of GBS, although it is not necessarily superior. However, further studies are needed to elucidate the mechanisms and to strengthen the results.
Abstract
Purpose: This study was aimed to evaluate the clinical value of gadolinium-enhanced spinal magnetic resonance imaging (MRI) in the diagnosis of Guillain-Barre syndrome (GBS) by comparing it with cerebrospinal fluid (CSF) and nerve conduction studies (NCS) in children. Method: A single center, retrospective analysis of clinical investigations undertaken in children with GBS over a 5-year period was performed. The patients’ respective medical records, including spinal MRIs and nerve conduction studies, were reviewed. Results: A total of seventeen children (mean age 5.3±3.6 years; males, 12, females, 5) were enrolled in the study. Twelve out of 17 children (71%) showed gadolinium nerve root enhancement, mostly anterior along with posterior roots (10/12, 83%) at 4.1 days of illness, compared to CSF (2/11, 11%) at 2.5 days and NCS (11/17, 64%) at 7.4 days of illness (P<0.05). In addition, it appeared the more severe symptoms showed more positive findings; however, the difference was statistically insignificant (P>0.05). Conclusion: In conclusion, NCS are a standard diagnostic tool for GBS. This study supports the gadolinium-enhanced spinal MRI as a valuable investigating technique in the early diagnosis of GBS, although it is not necessarily superior. However, further studies are needed to elucidate the mechanisms and to strengthen the results.
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