Child's Nervous System

, Volume 26, Issue 8, pp 1103–1108 | Cite as

Magnetic resonance imaging of childhood Guillain–Barre syndrome

  • Ali Yikilmaz
  • Selim Doganay
  • Hakan Gumus
  • Huseyin Per
  • Sefer Kumandas
  • Abdulhakim Coskun
Original Paper



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.


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).


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.


Guillain–Barre syndrome Magnetic resonance imaging Childhood Radiology 



We thank to Rusen Erez for his contribution in the statistical analyses.


  1. 1.
    Akyildiz B, Gümüs H, Kumandas S, Coskun A, Baykan A, Yikilmaz A, Kara I, Okur (2008) Guillain–Barré syndrome associated with Legionella infection. J Trop Pediatr 54:275–277CrossRefPubMedGoogle Scholar
  2. 2.
    Amit R, Shapira Y, Blank A, Aker M (1986) Acute, severe, central and peripheral nervous system combined demyelination. Pediatr Neurol 2:47–50CrossRefPubMedGoogle Scholar
  3. 3.
    Baran GA, Sowell MK, Sharp GB, Glasier CM (1993) MR findings in a child with Guillain–Barré syndrome. AJR 161:161–163PubMedGoogle Scholar
  4. 4.
    Bazan C 3rd, Jackson C, Jinkins JR, Barohn RJ (1991) Gadolinium-enhanced MRI in a case of cytomegalovirus polyradiculopathy. Neurology 41:1522–1523PubMedGoogle Scholar
  5. 5.
    Bertorini T, Halford H, Lawrence J, Vo D, Wassef M (1995) Contrast-enhanced magnetic resonance imaging of the lumbosacral roots in the dysimmune inflammatory polyneuropathies. J Neuroimaging 5:9–15PubMedGoogle Scholar
  6. 6.
    Byun WM, Park WK, Park BH, Ahn SH, Hwang MS, Chang JC (1998) Guillain–Barré syndrome: MR imaging findings of the spine in eight patients. Radiology 208:137–141PubMedGoogle Scholar
  7. 7.
    Crino PB, Zimmerman R, Laskowitz D, Raps EC, Rostami AM (1994) Magnetic resonance imaging of the cauda equina in Guillain–Barré syndrome. Neurology 44:1334–1336PubMedGoogle Scholar
  8. 8.
    Coskun A, Kumandas S, Pac A, Karahan OI, Gulec M, Baykara M (2003) Childhood Guillain–Barré syndrome. MR imaging in diagnosis and follow-up. Acta Radiol 44:230–235CrossRefPubMedGoogle Scholar
  9. 9.
    Gamstorp I (1974) Encephalo-myelo-radiculo-neuropathy: involvement of the CNS in children with Guillain–Barré–Strohl syndrome. Dev Med Child Neurol 16:654–658PubMedGoogle Scholar
  10. 10.
    Gorson KC, Ropper AH, Muriello MA, Blair R (1996) Prospective evaluation of MRI lumbosacral nerve root enhancement in acute Guillain–Barré syndrome. Neurology 47:813–817PubMedGoogle Scholar
  11. 11.
    Green SH (1976) Polyradiculitis (Landry–Guillain–Barré syndrome) with total external ophthalmoplegia: encephalo-myelo-radiculo-neuropathy. Dev Med Child Neurol 18:369–373PubMedGoogle Scholar
  12. 12.
    Hughes RA, Rees JH (1997) Clinical and epidemiological features of Guillain Barre syndrome. J Infections Dis 176:92–98CrossRefGoogle Scholar
  13. 13.
    Iwata F, Utsumi Y (1997) MR imaging in Guillain–Barré syndrome. Pediatr Radiol 27:36–38CrossRefPubMedGoogle Scholar
  14. 14.
    Johnson CE, Sze G (1990) Benign lumbar arachnoiditis: MR imaging with gadopentetate dimeglumine. AJR 155:873–880PubMedGoogle Scholar
  15. 15.
    Lim V, Sobel DF, Zyroff J (1990) Spinal cord pial metastases: MR imaging with gadopentetate dimeglumine. AJR 155:1077–1084PubMedGoogle Scholar
  16. 16.
    Morgan GW, Barohn RJ, Bazan C 3rd, King RB, Klucznik RP (1993) Nerve root enhancement with MRI in inflammatory demyelinating polyradiculoneuropathy. Neurology 43:618–620PubMedGoogle Scholar
  17. 17.
    Okumura A, Ushida H, Maruyama K, Itomi K, Ishiguro Y, Takahashi M, Osuga A, Negoro T, Watanabe K (2002) Guillain–Barré syndrome associated with central nervous system lesions. Arch Dis Child 86:304–306CrossRefPubMedGoogle Scholar
  18. 18.
    Patel H, Garg BP, Edwards MK (1993) MRI of Guillain–Barré syndrome. J Comput Assist Tomogr 17:651–652CrossRefPubMedGoogle Scholar
  19. 19.
    Seneviratne U (2000) Guillain–Barré syndrome. Postgrad Med J 76:774–782CrossRefPubMedGoogle Scholar
  20. 20.
    Talpos D, Tien RD, Hesselink JR (1991) Magnetic resonance imaging of AIDS-related polyradiculopathy. Neurology 41:1995–1997PubMedGoogle Scholar
  21. 21.
    Tam JK, Bradley WG Jr, Goergen SK, Chen DY, Pema PJ, Dubin MD, Teresi LM, Jordan JE (1996) Patterns of contrast enhancement in the pediatric spine at MR imaging with single- and triple-dose gadolinium. Radiology 198:273–278PubMedGoogle Scholar
  22. 22.
    Wilmshurst JM, Thomas NH, Robinson RO, Bingham JB, Pohl KR (2001) Lower limb and back pain in Guillain–Barré syndrome and associated contrast enhancement in MRI of the cauda equina. Acta Paediatr 90:691–694CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Ali Yikilmaz
    • 1
  • Selim Doganay
    • 1
  • Hakan Gumus
    • 2
  • Huseyin Per
    • 2
  • Sefer Kumandas
    • 2
  • Abdulhakim Coskun
    • 1
  1. 1.Department of Pediatric RadiologyErciyes University, School of Medicine, Children’s HospitalMelikgaziTurkey
  2. 2.Department of Pediatric NeurologyErciyes University, School of Medicine, Children’s HospitalMelikgaziTurkey

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