Simultaneous guillain-Barre syndrome and acute disseminated encephalomyelitis

Objective & Hypothesis:Acute disseminated encephalomyelitis (ADEM) and Guillain-Barré syndrome (GBS) are both immunologically mediated two inflammatory demyelinating diseases.

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Key Findings & Data:We report a 49- year- old male patient who developed numbness and mild weakness in all his extremities two weeks after an upper respiratory infection.

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Conclusion & Impact:The diagnosis was Guillain-Barré syndrome associated with ADEM.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Guillain-Barre sendromu · Tedavi sonucu · Prednizolon

Abstract

Acute disseminated encephalomyelitis (ADEM) and Guillain-Barré syndrome (GBS) are both immunologically mediated two inflammatory demyelinating diseases. The combined demyelinating process in the CNS and PNS is a rare occurrence. This may be explained by a shared epitope between peripheral and central nervous system myelin. We report a 49- year- old male patient who developed numbness and mild weakness in all his extremities two weeks after an upper respiratory infection. The elevated CSF protein levels and delayed F waves fulfilled the criteria of GBS. In a few days irritability and behavioral disturbances appeared. Cranial MRI revealed bilateral periventricular white matter and left hippocampus T2-weighted hyperintense ovoid lesions. Thoracal MRI revealed T1-weighted hypointense and T2-weighted hyperintense fusiform lesions at T3-4 and T10-11 levels with contrast enhancement. A diagnosis of acute disseminated encephalomyelitis (ADEM) was considered. After corticosteroid administration sensorial symptoms and urinary retention were improved. No clinical and radiological findings of a new attack were observed during the three year follow-up. The diagnosis was Guillain-Barré syndrome associated with ADEM.

Özet

Akut dissemine ensefalomiyelit (ADEM) ve Guillain-Barré sendromu (GBS) sinir sisteminin immun aracılı enflamatuvar, demiyelinizan, hastalıklarıdır. Santral ve periferik sinir sisteminin birlikte tutulduğu kombine demiyelinizan süreçlere nadir rastlanmaktadır. Bu durum santral ve periferik sinir sisteminde bulunan miyelin tarafından paylaşılan ortak bir epitop ile açıklanabilir. Bu yazıda üst solunum yolu enfeksiyonunu takiben 14. günde ekstremitelerinde uyuşukluk ve hafif güçsüzlük gelişen 49 yaşında bir erkek hasta sunulmuştur. Artmış BOS protein düzeyi ve kayıp F dalgaları bulguları, Guillan-Barré sendromu (GBS) kriterlerini karşılıyordu. Hastada, günler içinde sinirlilik ve davranış değişikliği ortaya çıkması üzerine yapılan, kranyal MRG tetkikinde periventriküler ve sol hipokampal T2 hiperintens ovoid lezyonlar, torakal MRG incelemesinde; T3-4, T10-11 seviyelerinde fusiform, kontrast tutan demiyelinizan lezyonlar görüldü. Bu bulgular, ADEM tanısı ile uyumluydu. Uygulanan kortikosteroid tedavi sonrası duysal semptomları ve üriner retansiyon düzeldi. Üç yıllık takibinde ise klinik atak ve radyoloji bulgu gözlenmedi. Tanı, GBS‘na eşlik eden ADEM olgusuydu

Keywords

Guillain-Barre sendromu Tedavi sonucu Prednizolon Orta yaşlı Erkek Manyetik rezonans görüntüleme Ensefalomiyelit akut dissemine Guillain-Barre Syndrome Treatment Outcome Prednisolone Middle Aged Male Magnetic Resonance Imaging Encephalomyelitis Acute Disseminated

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Cite This Article

TÜRKOĞLU, R., GENCER, M., ÇETİNKAYA, Y., TUTKAVUL, K., TİRELİ, H. (2009). Simultaneous guillain-Barre syndrome and acute disseminated encephalomyelitis. Nöropsikiyatri Arşivi, Cilt: 46 - Sayı: 2, 76–79. https://ajindex.com/articles/292741

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