Guillain‐BarrÉ syndrome subtype diagnosis: A prospective multicentric European study

Bergh, Peter Van den; Piéret, F; Woodard, John L.; Attarian, Shahram; Grapperon, Aude-Marie; Nicolas, Guillaume; Brisset, Marion; Cassereau, Julien; Rajabally, Yusuf A.; Parijs, Vinciane Van; Verougstraete, Donatienne; Jacquerye, P.; Raymackers, Jean-Marc; Redant, Céline; Michel, Claure; Delmont, Émilien

doi:10.1002/mus.26056

Cited by 30 publications

(28 citation statements)

References 33 publications

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“…To situate our study, we reviewed the existing literature from 2000 to present, with regards to neurophysiological studies in GBS. Most studies have investigated neurophysiological findings that were conducted more than 5 days after disease onset [4][5][6]. Early diagnosis and proper treatment administered could obtain satisfactory prognosis.…”

Section: Introductionmentioning

confidence: 99%

Very Early Neurophysiological Study in Guillain-Barre Syndrome

Jin

Qin

et al. 2018

Eur Neurol

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Purpose: The diagnosis of Guillain-Barre syndrome (GBS) in the very early stage may be challenging. Our aim was to report the neurophysiological abnormalities in GBS within 4 days of clinical onset. We expected that GBS will be diagnosed by the assistance of neurophysiological study in the very early stage. Methods: We prospectively recruited patients with a diagnosis of GBS discharged from First Affiliated Hospital of Xi’an Jiaotong University and Xi Jing Hospital. Patients were classified into 3 groups according to the onset of symptoms to electromyography examination interval (OEI). The neurophysiological findings were carried out using standard procedures. All patients were examined by the same experienced neurophysiologist. Results: There were not significant group differences in abnormal rate, distal motor latency (DML), motor nerve conduction velocity (MNCV), F response (FR), compound muscle action potential (CMAP), conduction block (CB), sensory nerve action potential (SNAP), and sensory nerve conduction velocity among OEI ≤4 days, 4< OEI ≤10 days, and OEI > 10 days groups. Motor nerves were more affected than sensory nerves in neurophysiological presentation in very early stage patients. The difference of motor nerves and sensory nerves was statistically significant in lower limbs, but was not in upper limbs. In motor nerve conduction studies, the abnormal rate of DML, MNCV, FR, CB was more common seen in ulnar and peroneal nerve than median and tibial nerve, the abnormal rate of CMAP was the same in ulnar, median, peroneal and tibial nerve. In sensory nerve conduction studies, the abnormal rate of ulnar nerve and median nerve was higher than the superficial peroneal nerve and sural nerve. The OEI was not correlated with the SNAP decrease rate of median (r = 0.10, p = 0.23) and ulnar (r = 0.26, p = 0.06) but was statistically correlated with sural SNAP decrease rate (r = 0.29, p = 0.04). The sural-sparing pattern phenomenon was the most commonly discovered phenomenon in very early stage patients (OEI ≤4 days), followed by patients with 4< OEI ≤10 days, ultimately found in patients with OEI > 10 days. Conclusions: We suggest performing neurophysiological examination as soon as possible for suspected GBS patients, particularly focusing on multi-spots inspection of ulnar and peroneal nerves, and paying close attention to sural-sparing patterns.

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Section: Introductionmentioning

confidence: 99%

Very Early Neurophysiological Study in Guillain-Barre Syndrome

Jin

Qin

et al. 2018

Eur Neurol

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“…In previous studies, male sex was more prominent in terms of sex distribution in patients with GBS (6,12,13,14). In the studies reported from our country, it is observed that male patients are in the majority (11,15,16).…”

Section: Discussionmentioning

confidence: 49%

“…Of these, approximately 50% were associated with respiratory and gastrointestinal tract infections, and this was consistent with the literature. In large-scale studies, respiratory infections and gastrointestinal tract infections have been reported as the most common preceding infections with a rate of 37.8-80% (6,12,14,15,17). In accordance with the literature, the presence of gastroenteritis as a preceding infection was considered as a poor prognostic factor (7,18).…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Prognosis in Patients with Guillain-Barré Syndrome

Çetiner¹,

Seyit²,

Akdağ³

et al. 2019

tnd

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Objective: We aimed to evaluate the demographic, clinical, laboratory and electrophysiological findings of patients with inpatient Guillain-Barré syndrome in our clinics and to investigate the effect of these parameters on the prognosis of the disease. Materials and Methods: Between January 2014 and April 2018, file records of patients admitted to our clinics with the diagnosis of Guillain-Barré syndrome were retrospectively reviewed. Demographic characteristics, clinical, laboratory and electrophysiological findings of the patients at the time of admission were recorded. Patients were clinically graded according to the Hughes classification at the time of admission and on the 3 rd month after discharge. Results: In the study, 25 of the 51 patients were male (49%) and 26 were female (51%) and the mean age was 54.21±17.32 years. According to clinical and electrophysiologic diagnosis, 34 patients (66.7%) had acute inflammatory demyelinating polyradiculoneuropathy, 9 patients (17.6%) had acute motor axonal neuropathy, 6 patients (11.8%) had acute motor sensory axonal neuropathy and 2 patients (3.9%) had Miller Fisher syndrome. According to Hughes scoring on the 3 rd month after discharge, 31 patients (60.8%) had in good prognosis (Hughes score ≤2) and 20 patients (39.2%) had in poor prognosis group (Hughes score >2). In the comparison between the two groups according to clinical, demographic, and laboratory parameters, older age (≥50), high Hughes score at admission, weakness in extremities as first complaint, the presence of complications, need for mechanical ventilation and presence of gastroenteritis as a leading infection were evaluated as prognostic factors. Conclusion: The most common variant of Guillain-Barré syndrome in our study was acute inflammatory demyelinating polyradiculoneuropathy. Older age (≥50), high Hughes score at admission, weakness in extremities as the first symptom, presence of complications, need for mechanical ventilation, and presence of gastroenteritis as a precursor infection were poor prognostic factors.

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“…However, despite several attempts to differentiate axonal GBS from AIDP using electrodiagnosis, no consensus has been achieved. The article in this issue of Muscle & Nerve by Van den Bergh et al 4 greatly helps in this debate.…”

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confidence: 99%

“…These was then modified to include temporal dispersion as a sign of segmental demyelination. The results of the study by Van den Bergh et al 4 were the following: (i) Comparing the initial EDX study to the second study did not change classification no matter what criteria was used. (ii) When comparing the different criteria, the Rajabally criteria had a lower percentage of demyelinating cases than the Ho or Hadden criteria which were similar (50% vs. 72.4% ).…”

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confidence: 99%

Electrophysiologic lessons from the European multicenter study of Guillain‐Barré syndrome subtype diagnosis

Lewis

2018

Muscle and Nerve

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Guillain‐BarrÉ syndrome subtype diagnosis: A prospective multicentric European study

Cited by 30 publications

References 33 publications

Very Early Neurophysiological Study in Guillain-Barre Syndrome

Very Early Neurophysiological Study in Guillain-Barre Syndrome

Factors Associated with Prognosis in Patients with Guillain-Barré Syndrome

Electrophysiologic lessons from the European multicenter study of Guillain‐Barré syndrome subtype diagnosis

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