The many faces of demyelinating diseases: acute disseminated encephalomyelitis and Guillain-Barré syndrome in the same patient

Acute disseminated encephalomyelitis and Guillain-Barre syndrome represent distinct demyelinating diseases that share an autoimmune pathogenesis. A history of viral infection or vaccination are essential for the diagnosis,,. A 26-month-old boy presented with fever 10 days after vaccination (inactivated polio vaccine and tetravalent), progressive drowsiness, lower limb strength/sensory loss and urinary retention. The cerebrospinal fluid showed mild pleocytosis and an elevated total protein concentration; it was negative for infections. The initial MRI study was compatible with acute disseminated encephalomyelitis, with no [...]