2026-07-21T16:08:01Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/160242024-11-29T10:51:06Zcom_20.500.12105_2052com_20.500.12105_2051com_20.500.12105_15322col_20.500.12105_19609col_20.500.12105_16979
Repisalud
author
Helfferich, Jelte
author
Roodbol, Joyce
author
de Wit, Marie-Claire
author
Brouwer, Oebele F
author
Jacobs, Bart C
author
2016 Enterovirus D68 Acute Flaccid Myelitis Working Group
author
Dutch Pediatric GBS Study Group
author
Cabrerizo, Maria
funder
Prinses Beatrix Spierfonds
2023-05-09T07:53:31Z
2023-05-09T07:53:31Z
2022-02
Eur J Neurol. 2022 Feb;29(2):593-604.
10.1111/ene.15170
1468-1331
European journal of neurology
34747551
http://hdl.handle.net/20.500.12105/16024
Background and purpose: Differentiation between acute flaccid myelitis (AFM) and Guillain-Barré syndrome (GBS) can be difficult, particularly in children. Our objective was to improve the diagnostic accuracy by giving recommendations based on a comparison of clinical features and diagnostic criteria in children with AFM or GBS. Methods: A cohort of 26 children with AFM associated with enterovirus D68 was compared to a cohort of 156 children with GBS. The specificity of the Brighton criteria, used for GBS diagnosis, was evaluated in the AFM cohort and the specificity of the Centers for Disease Control and Prevention (CDC) AFM diagnostic criteria in the GBS cohort. Results: Children with AFM compared to those with GBS had a shorter interval between onset of weakness and nadir (3 vs. 8 days, p < 0.001), more often had asymmetric limb weakness (58% vs. 0%, p < 0.001), and less frequently had sensory deficits (0% vs. 40%, p < 0.001). In AFM, cerebrospinal fluid leukocyte counts were higher, whereas protein concentrations were lower. Spinal cord lesions on magnetic resonance imaging were only found in AFM patients. No GBS case fulfilled CDC criteria for definite AFM. Of the AFM cases, 8% fulfilled the Brighton criteria for GBS, when omitting the criterion of excluding an alternate diagnosis. Conclusions: Despite the overlap in clinical presentation, we found distinctive early clinical and diagnostic characteristics for differentiating AFM from GBS in children. Diagnostic criteria for AFM and GBS usually perform well, but some AFM cases may fulfill clinical diagnostic criteria for GBS. This underlines the need to perform diagnostic tests early to exclude AFM in children suspected of atypical GBS.
eng
Brighton criteria
Guillain-Barré syndrome
Acute flaccid myelitis
Acute flaccid myelitis and Guillain-Barré syndrome in children: A comparative study with evaluation of diagnostic criteria
journal article
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