Abstract
A 15-year-old previously healthy female presented with lower extremity weakness and numbness, demonstrating imaging and laboratory characteristics diagnostic of both acute transverse myelitis (TM) and acute inflammatory demyelinating polyradiculopathy (AIDP). AIDP typically presents as a distinct clinical entity limited to the peripheral nervous system and nerve roots, but has been reported in association with central demyelinating syndromes including transverse myelitis. The signs and symptoms of the two syndromes may mimic one another and should always be considered in the differential diagnosis. Thus, careful investigation and a high index of suspicion are necessary to thoroughly exclude the coexistence of peripheral and central demyelination. When the conditions do co-occur, systemic inflammatory disease or infection should be considered and thoroughly investigated, as treatment must be directed toward any such underlying disease. In the rare case where no associated disease is identified, the treatment plan should independently consider recommendations for each demyelinating condition. Outcomes of AIDP versus central demyelinating syndromes vary considerably depending upon various prognostic factors, and it remains unclear how such prognosis translates to those cases with co-occurrence.
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References
Sejvar JJ, Baughman AL, Wise M, Morgan OW. Population incidence of Guillain-Barré syndrome: a systematic review and meta-analysis. Neuroepidemiology. 2011;36:123–33.
Fokke C, van den Berg B, Drenthen J, Walgaard C, van Doorn PA, Jacobs BC. Diagnosis of Guillain-Barré syndrome and validation of Brighton criteria. Brain. 2014;137(1):33–43.
Berman M, Feldman S, Alter M, Zilber N, Kahana E. Acute transverse myelitis incidence and etiologic considerations. Neurology. 1981;31(8):966–71.
Group TMCW. Proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology. 2002;59(4):499–505.
Scott TF, Frohman EM, Seze JD, Gronseth GS, Weinshenker BG. Evidence-based guideline: clinical evaluation and treatment of transverse myelitis report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2011;77(24):2128–34.
Wolf VL, Lupo PJ, Lotze TE. Pediatric acute transverse myelitis overview and differential diagnosis. J Child Neurol. 2012;27(11):1426–36.
Sindern E, Schröder JM, Krismann M, Malin JP. Inflammatory polyradiculoneuropathy with spinal cord involvement and lethal [correction of letal] outcome after hepatitis B vaccination. J Neurol Sci. 2001;186(1–2):81–5.
Bajaj NP, Rose P, Clifford-Jones R, Hughes PJ. Acute transverse myelitis and Guillain-Barré overlap syndrome with serological evidence for mumps viraemia. Acta Neurol Scand. 2001;104(4):239–42.
Mao Z, Hu X. Clinical characteristics and outcomes of patients with Guillain-Barré and acquired CNS demyelinating overlap syndrome: a cohort study based on a literature review. Neurol Res. 2014;36(12):1106–13.
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Cardon, A.L., Lotze, T.E. (2017). Transverse Myelitis with Acute Inflammatory Polyradiculoneuropathy. In: Waubant, E., Lotze, T. (eds) Pediatric Demyelinating Diseases of the Central Nervous System and Their Mimics. Springer, Cham. https://doi.org/10.1007/978-3-319-61407-6_30
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DOI: https://doi.org/10.1007/978-3-319-61407-6_30
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