Pediatric Acute Demyelinating Syndromes: Identification and Management in the Emergency Department

Points & Pearls Excerpt

• Demyelinating disorders are important to consider in pediatric patients presenting with weakness, and they can be differentiated from other pathologies by a careful history and thorough physical examination.
• Ascending paralysis is the classic presentation of Guillain-Barré syndrome (GBS). Common signs and symptoms of GBS are refusal to walk, neuropathic pain in the legs, absent deep tendon reflexes, and autonomic dysfunction.
• Symptoms of acute transverse myelitis (ATM) depend on the spinal level affected. Bilateral nonprogressing pain, weakness, and bowel/bladder dysfunction are common presenting symptoms.
• Patients with suspected GBS and respiratory distress with poor ventilation or oxygenation may require early advanced airway intervention.