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Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies

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Serial Nerve Conduction Studies in Guillain-Barré Syndrome: Its Usefulness and Precise Timing.

Hyung-Soo Lee¹, Bum Chun Suh², Jong Kuk Kim³

¹Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society

|March 4, 2024

Summary

Serial nerve conduction studies (NCSs) in Guillain-Barré syndrome (GBS) patients reveal significant classification changes early on. Follow-up NCS within 3 weeks is recommended for precise diagnosis in early-stage GBS.

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Area of Science:

Neurophysiology
Neurology
Clinical Electrophysiology

Background:

Nerve conduction studies (NCSs) are crucial for classifying Guillain-Barré syndrome (GBS).
Subclassification of GBS can evolve with serial NCSs.
The utility of serial NCSs in early-stage GBS remains debated.

Purpose of the Study:

To evaluate the usefulness of serial NCSs for GBS subclassification in the early disease stage.
To determine the frequency and timing of significant classification changes (SCCs) in GBS patients.

Main Methods:

Collected follow-up NCS data within 3 weeks (EFN) and 3-10 weeks (LFN) from 60 GBS patients.
First NCS (FN) was performed within 10 days of symptom onset.
Classified NCS into subtypes using Hadden's and Rajabally's criteria; analyzed SCCs and subtype shifts.

Main Results:

Significant classification changes (SCCs) were observed between FN and EFN in 18.3% (Rajabally) to 33.3% (Hadden) of patients.
Between FN and LFN, SCCs occurred in 21.7% (Rajabally) to 23.3% (Hadden), with most changes already evident by EFN.
Delayed SCCs were associated with very early FN, mild initial symptoms, or persistent electrophysiological deterioration.

Conclusions:

A considerable number of GBS patients exhibit significant neurophysiological classification changes in the early disease phase.
Serial NCSs appear beneficial for accurate GBS subclassification.
Recommend follow-up NCS within 3 weeks for GBS patients with initial NCS within 10 days of symptom onset.