Lower limb and back pain in Guillain-Barre syndrome and associated contrast enhancement in MRI of the cauda equina

This study assesses the frequency of lower limb and back pain in children w ith Guillain-Barre syndrome and reviews the magnetic resonance imaging resu lts of those undergoing spinal imaging. Over an 8-y period, nine children p resented with various combinations of severe back pain, leg pains, impairme nt of gait and bladder dysfunction. Guillain-Barre syndrome was confirmed o n clinical examination and peripheral electrophysiology (n = 8). Magnetic r esonance imaging in four patients, following contrast injection, showed enh ancement of the cauda equine and, additionally, of the cervical nerve roots in one of the patients. A further patient, who was not scanned with contra st, had abnormal thickening of the lumbar roots. Carbamazepine and steroids were effectively used for analgesia in three cases. All the patients recov ered. Conclusion: Guillain-Barre syndrome should be considered in the differentia l diagnosis of children presenting with back and/or leg pain. Early diagnos is ensures prompt monitoring for autonomic dysfunction and respiratory comp romise.