Acute transverse myelitis and Guillain-Barre overlap syndrome with serological evidence for mumps viraemia

Both acute transverse myelitis (ATM) and Guillain-Barre syndrome (GBS) occu r as rare associations with mulTIPS viraemia but to our knowledge, concurre nt ATM and GBS related to mumps has only been reported once previously. We describe the case of a young woman presenting with confusion and collapse 2 weeks after a flu-like illness. An initial diagnosis of transverse myeliti s was made on the basis of the clinical findings and radiological evidence of a swollen spinal cord with uniform high signal change on T-2 weighted MR I. The patient was treated with intravenous methylprednisolone without sign ificant recovery. The diagnosis was later revised to include GBS on the bas is of worsening facial diplegia in the setting of a flaccid tetraparesis, a nd neurophysiological evidence of a sensorimotor axonal polyradiculoneuropa thy. Acute mumps viraemia was confirmed on serological grounds. The patient made an improvement in ventilatory capacity with intravenous immunoglobuli n treatment.