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Acute demyelinating disorders can present with vague complaints and subtle abnormalities of the neurological examination. A thorough history and physical examination are important for narrowing the differential diagnosis and determining which diagnostic studies are indicated. This issue focuses on the most common acute demyelinating disorders in children: Guillain-Barré syndrome and acute transverse myelitis. Common presenting signs and symptoms of these conditions are reviewed, and evidence-based recommendations are provided for the initial assessment and management of Guillain-Barré syndrome and acute transverse myelitis in the emergency department.
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Following are the most informative references cited in this paper, as determined by the author.
9. * Lehmann HC, Hartung HP, Kieseier BC, et al. Guillain-Barré syndrome after exposure to influenza virus. Lancet Infect Dis. 2010;10(9):643-651. (Review article) DOI: 10.1016/S1473-3099(10)70140-7
35. * Agrawal S, Peake D, Whitehouse WP. Management of children with Guillain-Barré syndrome. Arch Dis Child Educ Pract Ed. 2007;92(6):161-168. (Review article) DOI: 10.1136/adc.2004.065706
36. * Patwa HS, Chaudhry V, Katzberg H, et al. Evidence-based guideline: intravenous immunoglobulin in the treatment of neuromuscular disorders: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2012;78(13):1009-1015. (Literature review) DOI: 10.1212/WNL.0b013e31824de293
40. * Korinthenberg R, Monting JS. Natural history and treatment effects in Guillain-Barré syndrome: a multicentre study. Arch Dis Child. 1996;74(4):281-287. (Multicenter retrospective chart review; 175 patients) DOI: 10.1136/adc.74.4.281
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Keywords: acute demyelinating syndromes, demyelinating syndromes, demyelinating conditions, Guillain-Barré syndrome, GBS, acute transverse myelitis, ATM, acute flaccid paralysis, acute inflammatory demyelinating polyradiculopathy, acute motor axonal neuropathy, Miller Fisher syndrome, weakness, back pain, deep tendon reflexes, respiratory distress, forced vital capacity, albuminocytologic dissociation, intravenous immunoglobulin, IVIG, corticosteroids, plasmapheresis, plasma exchange
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Camille Halfman, MD
Nicole Gerber, MD; Felicia Gliksman, DO, MPH; Kathleen G. Reichard, DO
March 2, 2021
April 1, 2024
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Date of Original Release: March 1, 2021. Date of most recent review: February 15, 2021. Termination date: March 1, 2024.
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