Very early electrodiagnostic findings in Guillain‐Barré syndrome

Abstract

Electrodiagnostic studies play a key role in the evaluation of patients with Guillain-Barré syndrome (GBS). However, at early stages patients may not meet current neurophysiologic criteria. We report electrodiagnostic findings for 18 patients with suspected GBS within 4 days of clinical onset. Fifteen patients (83%) showed abnormality in the motor nerve conduction study. Prolonged distal motor latency (DML) was the most frequent demyelinating parameter (seen in 55% of patients). Abnormal late responses were noted in 14 patients (77%). Electrodiagnostic study of cranial nerves was abnormal in eight (44%), and motor nerve conduction velocity was abnormal in only six patients (23%). The study shows a predominant motor neuropathy pattern followed by a sural-sparing pattern; no patients showed a strictly normal electrodiagnostic study. Reduced distal compound muscle action potential and prolonged DML in the demyelinating range were associated with severity of GBS on admission. After the electrodiagnostic study, 5 patients (27%) already fulfilled electrodiagnostic criteria for acute inflammatory demyelinating polyneuropathy (AIDP), 1 (5%) for the axonal variant of GBS, and 13 (72%) were classified as equivocal. We conclude that exhaustive electrodiagnostic studies of patients with suspected GBS in very early stages are useful in the diagnosis and management of the condition.

Very Early Neurophysiological Study in Guillain-Barre Syndrome

“…The onset to EMG interval OEI ≤4 days is considered to be a very early stage in neurophysiology [8]. Eleven patients were recruited in the very early stage group; they were identified based on the type of neurophysiological damage by following up for 3 months -6 patients had acute inflammatory demyelinating polyradiculoneuropathy (AIDP), 4 patients had acute motor sensory axonal neuropathy, and 1 patient was in unclassified form.…”

“…All recruited patients fulfilled standard clinical diagnostic criteria for GBS [7]. The exclusion criteria include GBS variants such as Miller-Fisher syndrome, pure sensory or ataxic syndromes, acute onset of chronic idiopathic polyneuropathy, diabetes, kidney disease, alcohol abuse, tumor and other cases can lead to peripheral nerve damage [8]. Fifty-one GBS patients (age 17-73 years, mean age 51.35 ± 14.74 years, 29 men, 22 women, male to female ratio 1.32: 1) were included in the study.…”

Insuficiencia respiratoria aguda en el Síndrome de Guillain Barré

“…aumento en la latencia motora distal › 150% o mayor al límite de lo normal 2. disminución en la velocidad de conducción ‹ 70% o menor al límite normal 3. aumento de la latencia de la onda F › 150 por encima del límite de lo normal 4. disminución compuesta de la amplitud del potencial de acción muscular superior al límite de lo 32,33 normal.…”

Elektromyografi og nevrografi ved alvorlig nevromuskulær sykdom

“…Nevrografi vil hos de fleste etter få dager vise patologiske funn (16). Ved akutt inflammatorisk demyeliniserende polynevropati finnes tegn på demyelinisering der de tidligste funnene er abnormale sene responser som tegn på proksimal demyelinisering i nervene, og i tillegg reduserte ledningshastigheter samt konduksjonsblokk grunnet fokal demyelinisering (illustrasjonen, nederst).…”

“…Nervus suralis er i mange tilfeller normal (16). Ved akutt motorisk aksonal polynevropati domineres nevrografifunnet av lave motoriske amplituder.…”