Electrodiagnostic features of the Guillain-Barré syndrome: the relative sensitivity of different techniques

We compared the diagnostic sensitivity of somatosensory evoked potentials (SEPs) and F waves with peripheral motor and sensory nerve conduction studies in 15 patients with the Guillain-Barré syndrome. All 4 types of studies were performed on 44 nerves (17 median, 12 ulnar, and 15 lower extremity). In the lower extremities, we used the peroneal nerves for all types of study except peripheral sensory conduction studies, which were performed on the sural nerve. We detected abnormalities by peripheral motor conduction studies in 33 of 44 nerves, by F waves in 31, by SEPs in 23, and by peripheral sensory conduction in 17. The cumulative sensitivity increased with the testing of multiple nerves by motor nerve conduction, sensory nerve conduction, and F-wave studies, but not with multiple SEPs. F-wave studies were significantly more sensitive than SEPs in identifying abnormalities. Thus, the recording of SEPs is indicated for diagnosis of the Guillain-Barré syndrome only if peripheral nerve conduction and F-wave studies are normal.