Objectives: Acute motor axonal neuropathy (AMAN) was first reported to be the main subtype of Guillain–Barré syndrome (GBS) in northern China in the 1990s. About 30 years has passed, and it is unknown whether the disease spectrum has changed over time in northern China. We aimed to study the epidemiological, clinical, and electrophysiological features of GBS in northern China in recent years. Methods: We retrospectively analyzed the medical records of GBS patients admitted to the Second Hospital of Hebei Medical University in northern China from 2015 to 2020. Results: A total of 294 patients with GBS were enrolled, with median age 53 years and 60.5% of participants being male, and a high incidence in summer and autumn. AMAN was still the predominant subtype in northern China (40.1%). The AMAN patients had shorter time to nadir, longer hospitalization time, and a more severe HFGS score at discharge than acute inflammatory demyelinating polyneuropathies (AIDP) (p < 0.05). With SPSS multivariable logistic regression analysis, we found the GBS disability score (at admission), dysphagia, and dysautonomia were independent risk factors for GBS patients requiring MV (p < 0.05). In comparison with other regions, the proportion of AMAN in northern China (40.1%) was higher than in eastern (35%) and southern (19%) China. Conclusions: AMAN is still the predominant subtype in northern China after 30 years, but there have been changes over time in the GBS spectrum since the 1990s. There are regional differences in GBS in China.

Ng et al. 1 recently reported a 25% prevalence of hypoperfusion-a >15% reduction of cerebral blood flow (CBF) or cerebral blood volume (CBV) from the mirror region on CT perfusion imaging-within the 24-hour infarct window, despite complete anterior circulation recanalization (TICI 2c/3), which negatively affected functional outcome. These findings contrast with our earlier finding of 6% (2/33) hypoperfused infarcts, where the 24-hour arterial spin labeling (ASL)-CBF images were analyzed according to the Alberta Stroke Program Early CT Score (ASPECTS) template. 2 We have reanalyzed our data set considering the entire middle cerebral arterial (MCA) territory, irrespective of ASPECTS. After excluding areas with confluent hemorrhagic transformation or parenchymal hematoma on the 24-hour MRI, consensus by 2 raters (kappa = 0.752) identified only 2 additional patients exhibiting patchy mild-to-moderate hypoperfusion with volumes too small to be reliably measured on ASL images, for a total prevalence of 4 of 33 patients (12%). After excluding patients with missing mRS (n = 2) or associated infarcts outside the MCA territory (n = 5), univariate analysis showed no significant association of "no-reflow" presence with a 3-month mRS of 0-1 or 0-2. A multivariate analysis was precluded by low occurrence of no-reflow. Taken together with this article and another recent report, 3 the prevalence of no-reflow after recanalized MCA stroke appears to stand

No abstract

No abstract