The following treatment options are useful in the management of Guiilain-Barre Syndrome except
. *Either high dose IV Ig or plasmapheresis can be initiated * IV Ig - 5 daily infusions for a total dose of 2g/kg body weight *Plasmapheresis -40-50ml/kg plasma exchange 4 times over a week. We describe an adolescent case of Guillain-Barre syndrome (GBS) mimicking acute methotrexate-associated encephalopathy during chemotherapy for lymphoblastic lymphoma. Although initial presentations of hemiparesis and irritability were suggestive of acute encephalopathy, the diminished deep tendon reflexes and subsequent rapid progression to flaccid triparesis with bulbar palsy were consistent with GBS. After the initiation of intravenous immunoglobulin therapy her symptoms improved rapidly, and the diagnosis of GBS was confirmed by nerve conduction studies and cerebrospinal fluid examination in recovery phase. GBS should be considered in the differential diagnosis of acute methotrexate-associated encephalopathy, although GBS is a rare neurologic complication Methotrexate is contraindicated in Gillian barre syndrome Ref Harrison20th edition pg 2245
Intra-venous immunoglobulin
Intra-venous methotrexate
Plasmapheresis
Physical medical rehabilitation
C.N.S