Systemic paediatrics: acute transverse myelitis versus Guillain-Barre syndrome: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Systemic paediatrics: acute transverse myelitis versus Guillain-Barre syndrome

Sample item

A 7-year-old has back pain followed within 24 hours by flaccid weakness of both legs, urinary retention and loss of sensation below the nipples. Knee jerks are absent initially. Which finding best favours this diagnosis over Guillain-Barre syndrome?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. A sensory level with early bladder involvement

Acute transverse myelitis causes a spinal cord syndrome with a sensory level, early sphincter involvement and eventually upper motor neuron signs, with spinal shock initially causing areflexia. Guillain-Barre syndrome causes ascending weakness without a sensory level and with late sphincter involvement.

Option by option

  • A. Albuminocytological dissociation in the CSF

    Albuminocytological dissociation is typical of Guillain-Barre syndrome.

  • B. A sensory level with early bladder involvement (correct)

    Correct. A sensory level with early bladder dysfunction localises to the spinal cord.

  • C. Bilateral facial weakness

    Bilateral facial weakness is common in Guillain-Barre syndrome and implies cranial nerve involvement.

  • D. Ascending symmetrical weakness with areflexia

    Ascending symmetrical weakness with areflexia is the classic Guillain-Barre pattern.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, A sensory level with early bladder involvement. Acute transverse myelitis causes a spinal cord syndrome with a sensory level, early sphincter involvement and eventually upper motor neuron signs, with spinal shock initially causing areflexia.

Why is "Albuminocytological dissociation in the CSF" not the answer?

Albuminocytological dissociation is typical of Guillain-Barre syndrome.

Why is "Bilateral facial weakness" not the answer?

Bilateral facial weakness is common in Guillain-Barre syndrome and implies cranial nerve involvement.

Why is "Ascending symmetrical weakness with areflexia" not the answer?

Ascending symmetrical weakness with areflexia is the classic Guillain-Barre pattern.

What concept does this question test?

It tests Systemic paediatrics: acute transverse myelitis versus Guillain-Barre syndrome in Pediatrics. Guillain-Barre syndrome causes ascending weakness without a sensory level and with late sphincter involvement.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic paediatrics: acute transverse myelitis versus Guillain-Barre syndrome?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.