Magnetic resonance imaging of childhood Guillain-Barre syndrome

Abstract

Objective: To describe the spinal magnetic resonance imaging (MRI) features in children with Guillain-Barre syndrome (GBS) and to investigate the correlation with the clinical/laboratory findings.

Material and methods: Clinical/laboratory findings of 40 children (mean age 5.7 years; range, 3 months-15 years) who had a final diagnosis of GBS were retrospectively reviewed. Clinical severity was graded according to Hughes classification. Electromyogram and cerebrospinal fluid analysis of the patients were recorded. All patients had a contrast-enhanced spinal MRI. The contrast enhancement pattern was determined, and the diameters of anterior and posterior spinal nerve roots were measured. The clinical/laboratory findings were correlated with the MRI findings.

Results: Twenty-eight patients had an electromyogram examination, and 25 of them revealed findings consistent with GBS. Cerebrospinal fluid analysis of 37 out of 40 patients showed albumino-cytologic dissociation. All but two patients had thickening and contrast enhancement of the nerve roots and cauda equina on spinal MRI. The most common MRI finding was enhancement of both the anterior and the posterior nerve roots of cauda equina which was prominent anteriorly. The mean anteroposterior diameter of the anterior nerve roots was 2.19 mm (range, 1.38-3.30 mm) and the posterior nerve root was 1.80 mm (range, 1.07-2.97 mm).

Conclusion: Spinal MRI is a reliable imaging method for the diagnosis of GBS as it was positive in 38 of 40 patients. The severity on MRI does not correlate with severity of the clinical condition. MRI can be used as a supplementary diagnostic modality to clinical and laboratory findings of GBS.