title: Concurrency of Guillain-Barre syndrome and acute transverse myelitis: a case report and review of literature.
abstract: 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.
authors.affiliation: Department of Pediatrics, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Orkun
authors.initials: O
authors.lastname: Tolunay
authors.affiliation: Department of Pediatrics, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Tamer
authors.initials: T
authors.lastname: Çelik
authors.affiliation: Department of Pediatrics, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Ümit
authors.initials: Ü
authors.lastname: Çelik
authors.affiliation: Department of Pediatrics, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kömür
authors.affiliation: Department of Pediatrics, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Tanyeli
authors.affiliation: Department of Neurology, Adana Numune Training and Research Hospital, Turkey and Research Hospital, Adana, Turkey.
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Sönmezler
keywords: Acute transverse myelitis; Guillain-Barré syndrome; Overlap syndrome