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Prognostic value of contrast-enhanced MRI in Guillain-Barré syndrome in children
F Althubaiti1, C Guiomard2, F Rivier3
1Département de Neuropédiatrie, CHU de Montpellier, Hôpital Gui de Chauliac, 34295, Montpellier, France; King Abdulaziz University, Department of Pediatrics, 21589, Jeddah, Saudi Arabia.
Insights
Contrast-enhanced MRI aids in diagnosing childhood Guillain-Barré syndrome. However, imaging patterns do not predict short-term or long-term clinical outcomes in pediatric patients.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Clinical Outcomes Research
Background:
- Childhood Guillain-Barré syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system.
- Contrast enhancement patterns on MRI can indicate nerve root inflammation in pediatric GBS.
Purpose of the Study:
- To investigate the prognostic value of contrast enhancement patterns in pediatric Guillain-Barré syndrome.
- To correlate imaging findings with clinical, laboratory, and therapeutic outcomes.
Main Methods:
- Retrospective analysis of 37 pediatric patients diagnosed with GBS between 2000 and 2016.
- Independent reinterpretation of MRI scans by a pediatric neuroradiologist and the first author.
- Comparison of MRI findings with clinical and laboratory data.
Main Results:
- The study included 37 patients (59.5% boys), aged 1.5-14.8 years.
- 73% of patients showed contrast enhancement or thickening of lumbosacral nerve roots.
- No significant correlation was found between MRI enhancement patterns and short-term or long-term outcomes.
Conclusions:
- Contrast-enhanced MRI is a sensitive diagnostic tool for acute inflammatory polyradiculopathy in children.
- The predictive value of MRI enhancement patterns for clinical and therapeutic outcomes in pediatric GBS remains unproven.
Background:
The aim of this retrospective study is to explore the prognostic value of different contrast enhancement imaging patterns in childhood Guillain-Barré syndrome by comparing the clinical, laboratory, and therapeutic outcomes.
Methods:
We included a total of 37 patients who were diagnosed and followed up by a pediatric neurology team at Montpellier University Hospital between 2000 and 2016. All images were reinterpreted by the first author and a senior pediatric neuroradiology staff member in two different sessions; in the case of disagreement, the expert's reading was considered.
Results:
The study group comprised 22 (59.5%) boys and 15 (40.5%) girls. The age ranged from 1.5 year to 14.8 years. Muscle weakness was present in 33 (89.2%) patients. Cranial nerves involvement was observed in 22 (59.5%) patients, while 29 (78.4%) patients had albuminocytological dissociation. In 27 (73%) patients, contrast enhancement or thickening of the lumbosacral nerve roots was found. Simultaneous spinal nerve root and cranial nerve enhancement was noted in five (17.2%) patients, while isolated cranial nerve enhancement was identified in three (10.3%) patients. Clinical and radiological cranial nerve involvement was found in seven (18.9%) patients, while isolated clinical cranial nerves involvement occurred in 13 (35.1%) patients. No significant correlation between different magnetic resonance imaging (MRI) enhancement patterns and short-term or long-term outcomes was found in our cohort.
Conclusion:
Contrast-enhanced brain and spinal MRI is a sensitive and recommended supportive test for diagnosing acute inflammatory polyradiculopathy in children. Its predictive value for clinical, and therapeutic outcomes in the short or long term has not yet been proved.
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