The prognostic value of demyelinating electrophysiologic findings and cerebrospinal fluid protein levels in acute inflammatory demyelinating polyneuropathy

Abstract

Background: Guillain-Barre syndrome is an acute immune-mediated polyneuropathy characterized by rapidly evolving symptoms and disability. Cerebrospinal fluid analysis and electrophysiological studies are crucial in the diagnosis of this syndrome. Objective: To evaluate the prognostic value of the type and number of demyelinating findings and cerebrospinal fluid protein levels in patients with acute inflammatory demyelinating polyneuropathy. Methods: We retrospectively analyzed electrophysiological data and cerebrospinal fluid of 67 consecutive patients with acute inflammatory demyelinating polyneuropathy from Istanbul, Turkey (2011-2019) studied ≤ 24 hours post-onset. Results: The patients who met a higher number of demyelinating criteria had increased disability scores in the first day and first month, and higher cerebrospinal fluid protein levels were correlated with worse prognosis both on the first day and the first month. However, the disability scores did not correlate with any single specific criterion, and no significant correlation was found between the number of satisfied criteria and cerebrospinal fluid protein levels. Conclusions: The number of demyelinating criteria that are met and high cerebrospinal fluid protein levels at the disease onset may be valuable prognostic markers. More systematic studies conducted with serial nerve conduction studies are required to highlight the roles of the suggested criteria in clinical practice.

Correlation of Total Protein in Cerebrospinal Fluid with the Type of Guillain-Barre Syndrome based on the Electrodiagnostic Examination at Prof. Dr. IGNG Ngoerah General Hospital Denpasar

“…Based on the analysis using Chi-square, there was no significant difference between the increase in total CSF protein to the GBS subtype based on the results of electrodiagnostic examination with a p value <0.05 (Table 5). (Tunç et al, 2020) An increase in total CSF protein indicates an increase in antibodies and myelin damage. The increase in total protein in CSF that occurs in the first week of onset is associated with an increase in the severity of GBS disease caused by swelling of the spinal roots resulting in disruption of CSF reabsorption.…”