{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:15:08Z","timestamp":1789949708722,"version":"4.0.1"},"reference-count":9,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,8,11]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>Guillain-Barr\u00e9 Syndrome (GBS) and cervical myelopathy are rare coexisting conditions in paediatric patients, often leading to significant diagnostic challenges due to their overlapping symptoms. We report a child who initially presented with lower motor neuron type of acute progressive ascending weakness, and a preceding infection, leading to a diagnosis of GBS. Intravenous immunoglobulin (IG) infusion was given, and the patient started improving on the eighth day of hospital stay, but there was emergence of upper motor neuron (UMN) signs, which prompted further evaluation. Spinal imaging revealed atlanto-axial dislocation (AAD) with cervical myelopathy due to os odontoideum and partial C2-C3 fusion. The compressive pathology was likely masked by GBS in the early stages, delaying recognition. While GBS affects peripheral nerves and cervical myelopathy results from spinal cord compression, their overlapping symptoms complicate differentiation. In cases of acute flaccid paralysis, spinal and cerebral MRI should be performed early to exclude surgically relevant lesions and to detect any contraindications to lumbar puncture, thereby facilitating timely and appropriate management.<\/jats:p>","DOI":"10.1136\/bcr-2025-266822","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T10:45:23Z","timestamp":1755859523000},"page":"e266822","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Uncommon concurrence of Guillain-Barr\u00e9 syndrome and cervical myelopathy in a paediatric patient: diagnostic challenge and clinical implications"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1272-3076","authenticated-orcid":false,"given":"Nikita","family":"Diwan","sequence":"first","affiliation":[{"name":"Paediatrics, King George's Medical College, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7122-7216","authenticated-orcid":false,"given":"Devina","family":"Singh","sequence":"additional","affiliation":[{"name":"Paediatrics, King George's Medical College, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandra Kanta","family":"Kumar","sequence":"additional","affiliation":[{"name":"Paediatrics, King George's Medical College, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yashwant Kumar","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, GSVM Medical College, Kanpur, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"2025082203451302000_18.8.e266822.1","doi-asserted-by":"crossref","first-page":"298","DOI":"10.3340\/jkns.2010.48.3.298","article-title":"Guillain-barr\u00e9 syndrome combined with acute cervical myelopathy","volume":"48","author":"Abai","year":"2010","journal-title":"J Korean Neurosurg Soc"},{"key":"2025082203451302000_18.8.e266822.2","first-page":"S43","article-title":"A study of Guillain-Barr\u00e9 syndrome with reference to cranial neuropathy and its prognostic implication","volume":"5","author":"Bhargava","year":"2014","journal-title":"J Neurosci Rural Pract"},{"key":"2025082203451302000_18.8.e266822.3","doi-asserted-by":"crossref","first-page":"1982","DOI":"10.1016\/j.radcr.2022.03.046","article-title":"Cervical myelopathy involving os odontoideum with retro-odontoid cyst and atlanto-axial instability: A case report","volume":"17","author":"Guerrouj","year":"2022","journal-title":"Radiol Case Rep"},{"key":"2025082203451302000_18.8.e266822.4","first-page":"3577693","article-title":"Fusion of the 2nd with the 3rd Cervical Vertebrae (C2-C3): A Case Series with Possible Clinical Significance","volume":"2023","author":"Demeneopoulou","year":"2023","journal-title":"Case Rep Orthop"},{"key":"2025082203451302000_18.8.e266822.5","doi-asserted-by":"crossref","first-page":"S161","DOI":"10.3345\/kjp.2016.59.11.S161","article-title":"Concurrency of Guillain-Barre syndrome and acute transverse myelitis: a case report and review of literature","volume":"59","author":"Tolunay","year":"2016","journal-title":"Korean J Pediatr"},{"key":"2025082203451302000_18.8.e266822.6","doi-asserted-by":"crossref","first-page":"745","DOI":"10.5535\/arm.2013.37.5.745","article-title":"Syringomyelia coexisting with guillain-barre syndrome","volume":"37","author":"Kim","year":"2013","journal-title":"Ann Rehabil Med"},{"key":"2025082203451302000_18.8.e266822.7","doi-asserted-by":"crossref","first-page":"38207073","DOI":"10.2106\/JBJS.CC.23.00533","article-title":"Cervical Myelopathy with Concomitant Guillain-Barr\u00e9 Syndrome: A Case Report","volume":"14","author":"Neaville","year":"2024","journal-title":"JBJS Case Connect"},{"key":"2025082203451302000_18.8.e266822.8","doi-asserted-by":"crossref","first-page":"290","DOI":"10.4172\/2165-7939.1000290","article-title":"Coincidence of Guillain-Barre Syndrome in a Patient with Cervical Spondylotic Myelopathy, A Case Report","volume":"05","author":"M. Al Harbi","year":"2016","journal-title":"J Spine"},{"key":"2025082203451302000_18.8.e266822.9","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2021-246967","article-title":"A possible Guillain-Barr\u00e9 syndrome\/transverse myelitis overlap syndrome after recent COVID-19","volume":"15","author":"Alrubaye","year":"2022","journal-title":"BMJ Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-266822","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T10:45:25Z","timestamp":1755859525000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-266822"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":9,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,22]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/bcr-2025-266822"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-266822","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}