Electrodiagnosis of Guillain-Barre syndrome in the International GBS Outcome Study: Differences in methods and reference values

Arends, Samuel; Drenthen, Judith; Bergh, Peter Van den; Franssen, Hessel; Hadden, Robert DM; Islam, Badrul; Kuwabara, Satoshi; Reisin, Ricardo; Shahrizaila, Nortina; Amino, Hiroshi; Antonini, Giovanni; Attarian, Shahram; Balducci, Claudia; Barroso, Fabio; Bertorini, Tulio E.; Binda, Davide; Brannagan, Thomas H.; Buermann, Jan; Casasnovas, Carlos; Cavaletti, Guido; Chao, Chi‐Chao; Dimachkie, Mazen M.; Fulgenzi, E.; Galassi, Giuliana; Gutiérrez-Gutiérrez, Gerardo; Harbo, Thomas; Hartung, Hans‐Peter; Hsieh, Sung‐Tsang; Kiers, Lynette; Lehmann, Helmar C.; Manganelli, Fiore; Marfia, Girolama Alessandra; Mataluni, Giorgia; Pardo, Julio; Péreón, Yann; Rajabally, Yusuf A.; Santoro, Lucio; Sekiguchi, Yukari; Stein, Beth E. Shubin; Mark, S.; Uncini, Antonino; Verboon, Christine; Verhamme, Camiel; Vytopil, Michal; Waheed, Waqar; Wang, Min; Živković, Sasha; Jacobs, Bart C.; Cornblath, David R.

doi:10.1016/j.clinph.2021.12.014

Cited by 11 publications

(4 citation statements)

References 22 publications

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Section: Discussionmentioning

confidence: 99%

“…NCS protocol in GBS (e.g., number of tested nerves) varies broadly worldwide with no minimum standard for EDX ( Arends et al, 2022 ). The range of sensory NCS is 0–10 sensory nerves (median: 4, IQR: 3–5) in GBS ( Arends et al, 2022 ). Since abnormal SNAPs were confined in one upper limb in approximately 30 % of sural-sparing, it could be missed if sensory NCS was conducted in one upper limb, despite a complete study of the three nerves.…”

Section: Discussionmentioning

confidence: 99%

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Sural-sparing pattern: A study against electrodiagnostic subtypes of Guillain–Barre syndrome

Pasutharnchat

Ratanasirisawad

Santananukarn

et al. 2022

Clinical Neurophysiology Practice

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sural-sparing pattern: A study against electrodiagnostic subtypes of Guillain–Barre syndrome

Pasutharnchat

Ratanasirisawad

Santananukarn

et al. 2022

Clinical Neurophysiology Practice

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“…The current study is based on the first 1500 patients included in IGOS, a prospective observational cohort study [ 12 ]. A description of the collection of NCS data in IGOS has been published previously [ 14 ]. Inclusion criteria were fulfilment of the diagnostic criteria for GBS (of the National Institute of Neurological Disorders and Stroke) or one of the clinical variants, the presence of NCS with at least two motor nerves examined, and patients presenting within 2 weeks after onset of GBS‐related symptoms.…”

Section: Methodsmentioning

confidence: 99%

“…Demographic and clinical data were obtained from the IGOS database. Patients were classified into one of the following clinical variants: sensorimotor, pure motor, Miller Fisher syndrome (MFS), MFS‐GBS overlap syndrome, ataxic, pure sensory and pharyngeal–cervical–brachial variants [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

Electrodiagnostic subtyping in Guillain–Barré syndrome patients in the International Guillain–Barré Outcome Study

Arends,

Drenthen,

de Koning

et al. 2024

Euro J of Neurology

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Background and purposeVarious electrodiagnostic criteria have been developed in Guillain–Barré syndrome (GBS). Their performance in a broad representation of GBS patients has not been evaluated. Motor conduction data from the International GBS Outcome Study (IGOS) cohort were used to compare two widely used criterion sets and relate these to diagnostic amyotrophic lateral sclerosis criteria.MethodsFrom the first 1500 patients in IGOS, nerve conduction studies from 1137 (75.8%) were available for the current study. These patients were classified according to nerve conduction studies criteria proposed by Hadden and Rajabally.ResultsOf the 1137 studies, 68.3% (N = 777) were classified identically according to criteria by Hadden and Rajabally: 111 (9.8%) axonal, 366 (32.2%) demyelinating, 195 (17.2%) equivocal, 35 (3.1%) inexcitable and 70 (6.2%) normal. Thus, 360 studies (31.7%) were classified differently. The areas of differences were as follows: 155 studies (13.6%) classified as demyelinating by Hadden and axonal by Rajabally; 122 studies (10.7%) classified as demyelinating by Hadden and equivocal by Rajabally; and 75 studies (6.6%) classified as equivocal by Hadden and axonal by Rajabally. Due to more strictly defined cutoffs fewer patients fulfilled demyelinating criteria by Rajabally than by Hadden, making more patients eligible for axonal or equivocal classification by Rajabally. In 234 (68.6%) axonal studies by Rajabally the revised El Escorial (amyotrophic lateral sclerosis) criteria were fulfilled; in axonal cases by Hadden this was 1.8%.Conclusions and discussionThis study shows that electrodiagnosis in GBS is dependent on the criterion set utilized, both of which are based on expert opinion. Reappraisal of electrodiagnostic subtyping in GBS is warranted.

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Expanding our understanding of Guillain–Barré syndrome: Recent advances and clinical implications

Ripellino,

Schreiner,

Latorre

2024

Eur J Immunol

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Guillain–Barré syndrome (GBS) is a rare yet potentially life‐threatening disorder of the peripheral nervous system (PNS), characterized by substantial clinical heterogeneity. Although classified as an autoimmune disease, the immune mechanisms underpinning distinct GBS subtypes remain largely elusive. Traditionally considered primarily antibody‐mediated, the pathophysiology of GBS lacks clarity, posing challenges in the development of targeted and effective treatments. Nevertheless, recent investigations have substantially expanded our understanding of the disease, revealing an involvement of autoreactive T cell immunity in a major subtype of GBS patients and opening new biomedical perspectives. This review highlights these discoveries and offers a comprehensive overview of current knowledge about GBS, including ongoing challenges in disease management.

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Electrodiagnosis of Guillain-Barre syndrome in the International GBS Outcome Study: Differences in methods and reference values

Cited by 11 publications

References 22 publications

Sural-sparing pattern: A study against electrodiagnostic subtypes of Guillain–Barre syndrome

Sural-sparing pattern: A study against electrodiagnostic subtypes of Guillain–Barre syndrome

Electrodiagnostic subtyping in Guillain–Barré syndrome patients in the International Guillain–Barré Outcome Study

Expanding our understanding of Guillain–Barré syndrome: Recent advances and clinical implications

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