Presence of repeater F‐waves in the early stage of Guillain‐Barré syndrome

Geijo-Barrientos, Emilio; González, Ofelia; Pastore-Olmedo, Carlos

doi:10.1111/j.1529-8027.2012.00383.x

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…A possible explanation for this discrepancy could be that in AMAN cases characterized by reversible conduction failure, A‐waves disappear in follow‐up studies while F‐wave persistence recovers (Figure 3). Regarding Freps frequency in early stages of GBS, our results are in agreement with Geijo‐Barrientos et al, who previously reported an increased presence of Freps in lower limb nerves 11 …”

Section: Discussionsupporting

confidence: 93%

“…The presence of repeater F‐waves (Freps) and A‐waves are not routinely studied in GBS patients. An increased frequency of Freps has been reported in various neuropathies including GBS 6‐11 . A‐waves are observed in both acute and chronic neurogenic conditions that vary widely in underlying pathophysiological mechanisms 12 .…”

Section: Introductionmentioning

confidence: 99%

“…An increased frequency of Freps has been reported in various neuropathies including GBS. [6][7][8][9][10][11] A-waves are observed in both acute and chronic neurogenic conditions that vary widely in underlying pathophysiological mechanisms. 12 They occasionally appear in the tibial nerve of healthy, older age subjects.…”

Section: Introductionmentioning

confidence: 99%

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Identical late motor responses in early Guillain‐Barré syndrome: A‐waves and repeater F‐waves

Veltsista

Kefalopoulou

Kintos

et al. 2022

J Peripheral Nervous Sys

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Electrodiagnostic (EDx) studies play a key role in the investigation of suspected Guillain‐Barré syndrome (GBS), providing diagnostic and prognostic information. However, initial EDx findings may not fulfill the neurophysiological criteria for the disease. The aim of this study was to estimate the occurrence and characteristics of A‐waves and repeaters F‐waves (Freps), both late motor responses identical in latency and configuration, in early stages of GBS. We retrospectively analyzed the initial nerve conduction study (NCS) of 26 GBS patients performed within 10 days from symptom onset. The final subtype diagnosis was acute inflammatory demyelinating polyneuropathy (AIDP) in 16 patients (six met the criteria at the initial EDx study and 10 at follow‐up) and acute motor axonal neuropathy (AMAN) in 10 patients (six initially). Identical late responses were commonly found in the majority of nerves (84%). A‐waves were present in 59% and an increased frequency of Freps was calculated in 61% of the 105 studied nerves. A‐waves morphology (single or complex) could not distinguish between AIDP and AMAN. Nerves with normal NCS had a significantly higher frequency of A‐waves, either isolated or in combination with increased index total Freps, as compared to nerves with low compound muscle action potential (CMAP) amplitudes or conduction block. Our findings suggest that both late responses can be useful as early markers of conduction changes of various pathophysiology, being frequently present even prior to abnormalities of CMAP parameters.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Identical late motor responses in early Guillain‐Barré syndrome: A‐waves and repeater F‐waves

Veltsista

Kefalopoulou

Kintos

et al. 2022

J Peripheral Nervous Sys

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“…The characteristic finding of F‐waves in polio survivors was abundant repeater F‐waves with a high occupancy rate. The occurrence of repeater F‐waves has been demonstrated in carpal tunnel syndrome, motor neuron disease, cervical spondylosis, lumbosacral radiculopathy, and Guillain‐Barré syndrome . The ORFs of the polio group were approximately 4‐46 times greater than those of the control group.…”

Section: Discussionmentioning

confidence: 99%

Repeater F‐waves are signs of motor unit pathology in polio survivors

et al. 2015

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Introduction The purpose of this study was to determine whether F‐waves reveal electrophysiological features of anterior horn cells in polio survivors. Methods Forty‐three polio survivors and 20 healthy controls underwent motor nerve conduction studies of the median and tibial nerves bilaterally, including sampling of F‐waves elicited by 100 stimuli and the determination of motor unit number estimation (MUNE). Results A significant increase in abnormally stereotyped (“repeater”) F–waves and a reduction of F‐wave persistence were observed in both nerves in the polio group as compared with the control group. Repeater F‐waves had a negative correlation with MUNE. Conclusions These trends in F‐wave persistence and repeater F‐waves after motor unit loss are characteristic findings in polio survivors. Repeater F‐waves are a sign of motor unit pathology. Muscle Nerve 51 :680–685, 2015

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“…The response may be motor or sensory, depending on the nerve involved) [ 6 ]; prolonged or repeater F-waves (a F-wave is obtained via supramaximal stimulation of the motor nerve in the distal site. This causes the stimulus to reach the proximal (toward the neurons of the spinal cord) motor neurons and they fire, leading to a stimulus, which is measured as the F-wave) [ 7 ] along with conduction blocks [ 8 ]; and increased A-waves (an A-wave is recorded during routine F-wave studies. It appears during the acute stage of AIDP.…”

Section: Guillain–barre Syndromementioning

confidence: 99%

Immune-Mediated Neuropathies: Pathophysiology and Management

Shastri

Aiyan

Kishore

et al. 2023

IJMS

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Dysfunction of the immune system can result in damage of the peripheral nervous system. The immunological mechanisms, which include macrophage infiltration, inflammation and proliferation of Schwann cells, result in variable degrees of demyelination and axonal degeneration. Aetiology is diverse and, in some cases, may be precipitated by infection. Various animal models have contributed and helped to elucidate the pathophysiological mechanisms in acute and chronic inflammatory polyradiculoneuropathies (Guillain–Barre Syndrome and chronic inflammatory demyelinating polyradiculoneuropathy, respectively). The presence of specific anti-glycoconjugate antibodies indicates an underlying process of molecular mimicry and sometimes assists in the classification of these disorders, which often merely supports the clinical diagnosis. Now, the electrophysiological presence of conduction blocks is another important factor in characterizing another subgroup of treatable motor neuropathies (multifocal motor neuropathy with conduction block), which is distinct from Lewis–Sumner syndrome (multifocal acquired demyelinating sensory and motor neuropathy) in its response to treatment modalities as well as electrophysiological features. Furthermore, paraneoplastic neuropathies are also immune-mediated and are the result of an immune reaction to tumour cells that express onconeural antigens and mimic molecules expressed on the surface of neurons. The detection of specific paraneoplastic antibodies often assists the clinician in the investigation of an underlying, sometimes specific, malignancy. This review aims to discuss the immunological and pathophysiological mechanisms that are thought to be crucial in the aetiology of dysimmune neuropathies as well as their individual electrophysiological characteristics, their laboratory features and existing treatment options. Here, we aim to present a balance of discussion from these diverse angles that may be helpful in categorizing disease and establishing prognosis.

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Presence of repeater F‐waves in the early stage of Guillain‐Barré syndrome

Cited by 6 publications

References 13 publications

Identical late motor responses in early Guillain‐Barré syndrome: A‐waves and repeater F‐waves

Identical late motor responses in early Guillain‐Barré syndrome: A‐waves and repeater F‐waves

Repeater F‐waves are signs of motor unit pathology in polio survivors

Immune-Mediated Neuropathies: Pathophysiology and Management

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