CMT AND NEUROGENIC DISEASE: P.336Imaging findings in patients with Guillain-Barré syndrome

Abstract

To describe magnetic resonance imaging (MRI) findings in patients with Guillain-Barré syndrome (GBS). A retrospective and descriptive study was conducted. The clinical charts of 99 patients with the suspicion of GBS seen between 2013 and 2017 were reviewed. GBS diagnosis was confirmedin 81 patients; 47 without MRIstudies were excluded. Complete MRI with and without gadolinium of the spine was performedin 34 patientsand of the brain in 17. Thickening and enhancement of the anterior and posterior roots of the cauda equina and of the cervicalcordwere assessed on MRI. Median age of the patients was 4 years, ranging from 6 months to 16 years; 23 were boys. MRI was performed between 2 and 37 days after symptom onset (median 6 days). EMG: AIDP 31, AMSAN 1, AMAN 1, normal 1. Thirty of 34 patients (88%) had abnormalities on the MRI. Thickening and enhancement of the cauda equina rootswas seen in 28 (82%) patients: involvement of the anterior and posterior roots in 15 (44%) and anterior roots in 13 (38%); cervical root involvement was observed in 17 (50%). The MRI was normal in four (11%). From those who had posterior root involvement, only 11 experienced pain. Cervical involvement was observed in 17, of whom 15 had upper-limb weakness, however 15 patients with clinical weakness had normal cervical MRI. Cranial nerve involvement was seen in 3 patients, of whom 2 had clinical impairment, but 14 had clinical manifestation without MRI abnormalities. Characteristic features may be observed in MRI, even in the early stages of GBS. Cauda equina root thickening and enhancement are the most common findings. No clear correlation was found either between the imaging findings and disease severity and pain or between cervical involvement and upper-limb manifestations. MRI may be a useful study to support the diagnosis of GBS.