title: Investigation of suspected Guillain-Barre syndrome in childhood: what is the role for gadolinium enhanced magnetic resonance imaging of the spine?
abstract: OBJECTIVE
  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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Departments of Neurology and Medical Imaging, Sydney Children's Hospital, Randwick, New South Wales, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Smith
authors.forename: John
authors.initials: J
authors.lastname: Pereira
authors.forename: Padraic
authors.initials: P
authors.lastname: Grattan-Smith
mesh_terms: D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium; D020275:Guillain-Barre Syndrome / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009431:Neural Conduction / Q000502:physiology; D009460:Neurologic Examination / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013131:Spine / Q000473:pathology*
chemical_list: D005682:Gadolinium