Concomitant Guillain-Barré Syndrome and Acute Transverse Myelitis in an Older Adult-A Case Report.
PURPOSE
Guillain-Barré syndrome concomitant with spinal cord involvement, which is defined as Guillain-Barré syndrome and acute transverse myelitis overlap syndrome, is rarely seen in the elders. Here we present a 68-year-old female patient who developed Guillain-Barré syndrome, as well as acute transverse myelitis at the same episode.


CASE REPORT
This patient developed acute weakness of lower limbs, which then rapidly became tetraplegia and hyporeflexia within 5 days. She also had impaired pinprick and vibration sensations below T4, as well as urinary and defecation incontinence. The nerve conduction studies revealed a motorsensory axonal neuropathy. Cerebrospinal fluid analysis showed albuminocytological dissociation and elevated IgG index. The spinal magnetic resonance imaging study revealed heterogeneously contrastenhanced, long-segmental intramedullary lesion from C2 to T3. Other laboratory findings, including blood anti-aquaporin 4 antibody, were not remarkable. The patient's tetraplegia was gradually improved by plasmapheresis and methylprednisolone pulse therapy.


CONCLUSION
Although Guillain-Barré syndrome and acute transverse myelitis overlap syndrome is occasionally seen in young adults, it could still occur in the elderly patients. Plasmapheresis and steroid pulse therapy could be beneficial to improve functional outcome of patients with this immunemediated neurological disease.
['Wu|Ching-I|CI|', 'Wu|Chia-Lun|CL|', 'Chang|Kuo-Hsuan|KH|', 'Huang|Wen-Yi|WY|']
D000368:Aged D005260:Female D020275:Guillain-Barre Syndrome D006801:Humans D008279:Magnetic Resonance Imaging D009188:Myelitis, Transverse
Acute transverse myelitis Demyelinating disease Guillain-Barré syndrome treatment.