Kosin Medical Journal (고신대학교 의과대학 학술지)

Kosin University College of Medicine (고신대학교 의과대학)
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Acute combined central and peripheral nervous system demyelination: a case report

  • Roh, Young Eun (Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Kim, Young Mi (Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine)
  • Received : 2016.01.08
  • Accepted : 2016.05.23
  • Published : 2018.12.31
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Abstract

Guillain-$Barr{\acute{e}}$ syndrome (GBS) and acute disseminated encephalomyelitis (ADEM) are demyelinating neurologic disorders with different target organs. Although they share similar pathogenetic mechanism, reports of simultaneous occurrence of the 2 disorders are rare. A 2 year 6 month old girl visited our hospital for fever, cough, and general weakness. Although the muscle power of extremities showed mild weakness and voiding difficulty, initial deep tendon reflex of both knees and ankles was normal. A nerve conduction study to evaluate the weakness revealed the absence of F waves. Cerebrospinal fluid analysis demonstrated pleocytosis with lymphocyte predominance and elevated protein levels. Magnetic resonance imaging showed abnormal T2 hyperintensity in pons, medulla and spinal cord. Serum anti-GD1b antibody was positive. Based on clinical findings, laboratory findings, nerve conduction study, and neuroimaging, the diagnosis of GBS and ADEM was made. This is the first case of GBS accompanied by ADEM in Korea.

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