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

J Paediatr Child Health. 2014 Oct;50(10):E72-6. doi: 10.1111/j.1440-1754.2010.01802.x. Epub 2010 Jul 7.

Abstract

Aim: To review the role of gadolinium-enhanced magnetic resonance imaging of the spine in the diagnosis of paediatric Guillain-Barre syndrome and compare it with nerve conduction studies and cerebrospinal fluid analysis.

Methods: A retrospective review of investigations undertaken in children admitted to our institution with acute Guillain-Barre syndrome over a 10-year period was performed.

Results: Seven of eight children (88%) displayed post-gadolinium nerve root enhancement consistent with Guillain-Barre syndrome. This compared with supportive nerve conduction studies in 21/24 children (88%) and cerebrospinal fluid protein analysis consistent with the diagnosis in 16/20 children (80%).

Conclusion: Nerve conduction studies are the recognised 'gold standard' technique for confirming a clinical diagnosis of Guillain-Barre syndrome. In this study, a high positive rate was demonstrated. While more experience is necessary, this study and the literature support gadolinium enhanced magnetic resonance imaging of the spine as a valuable, although not necessarily superior, investigation in the diagnosis of Guillain-Barre syndrome. It may be of particular benefit when specialist neurophysiology expertise is unavailable.

Keywords: Guillain-Barre syndrome; magnetic resonance imaging; neurophysiology; paediatric.

Publication types

  • Comparative Study

MeSH terms

  • Child
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Gadolinium*
  • Guillain-Barre Syndrome / cerebrospinal fluid
  • Guillain-Barre Syndrome / diagnosis*
  • Humans
  • Image Enhancement*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Neural Conduction / physiology
  • Neurologic Examination / methods
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Spine / pathology*

Substances

  • Gadolinium