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Optimizing electrodiagnosis for Guillain-Barré syndrome: Clues from clinical practice
Yusuf A Rajabally1,2, Fu Liong Hiew2
1School of Life and Health Sciences, Aston Brain Centre, Aston University, Aston Triangle, Birmingham, B4 7ET, UK.
Introduction:
The most efficient method of performing electrophysiology for Guillain-Barré syndrome (GBS) is unknown.
Methods:
We retrospectively analyzed electrophysiological data of 97 consecutive GBS patients from Birmingham, UK (2001-2012), studied ≤ 3 weeks post-onset.
Results:
The sensitivity of electrophysiology for each GBS subtype was dependent on the upper and lower limb nerves tested. In acute inflammatory demyelinating polyneuropathy (AIDP), abnormalities were predominant in the arms, whereas leg abnormalities predominated in axonal GBS. In AIDP, the most common abnormal parameters were distal motor latency and conduction block, and the most frequently affected nerve was the median. In axonal GBS, reduced motor amplitudes and conduction block were the most common parameters, and the most frequently abnormal nerve was the tibial.
Conclusions:
Electrodiagnostic sensitivity in GBS is dependent on nerves tested and parameters considered. Each subtype preferentially involves specific nerves and parameters. These findings may help per-procedure interpretation, improve electrodiagnostic sensitivity, and reduce patient discomfort. Muscle Nerve 55: 748-751, 2017.
