Acute demyelinating disorders can present with vague complaints and subtle abnormalities of the neurological examination. A thorough history and physical examination are impor- tant for narrowing the differential diagnosis and determining which diagnostic studies are indicated.
Our recent issue Pediatric Acute Demyelinating Syndromes: Identification and Management in the Emergency Department focuses on the most common acute demyelinating disorders in children: Guillain-Barré syndrome and acute transverse myelitis.
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Here are a few key points:
- 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.
Last Updated on December 13, 2021