The utility of sural-sparing pattern in the electrodiagnosis of regional subtypes of Guillain-Barré Syndrome.
| Autor: | Umapathi T; National Neuroscience Institute, 11, Jalan Tan Tock Seng, Singapore 308433, Singapore., Koh JS; National Neuroscience Institute, 11, Jalan Tan Tock Seng, Singapore 308433, Singapore., Cheng YJ; National Neuroscience Institute, 11, Jalan Tan Tock Seng, Singapore 308433, Singapore., Goh EJH; National Neuroscience Institute, 11, Jalan Tan Tock Seng, Singapore 308433, Singapore., Lim CSJ; National Neuroscience Institute, 11, Jalan Tan Tock Seng, Singapore 308433, Singapore. |
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| Jazyk: | angličtina |
| Zdroj: | Clinical neurophysiology practice [Clin Neurophysiol Pract] 2020 Feb 07; Vol. 5, pp. 43-45. Date of Electronic Publication: 2020 Feb 07 (Print Publication: 2020). |
| DOI: | 10.1016/j.cnp.2019.12.002 |
| Abstrakt: | Objective: We present an exemplar patient, illustrating utility of the sural-sparing pattern in diagnosis of Guillain-Barré Syndrome (GBS). We then present data that sheds light on the pathophysiology of sural-sparing. Method and Results: We describe a case of complex ophthalmoplegia that exemplifies the challenge of diagnosing regional subtypes of Guillain-Barré Syndrome, and the value of scrutinizing sensory nerve action potentials for the sural-sparing pattern. We also demonstrate, in a series of GBS patients, how serial nerve conduction studies can reveal "covert" sural-sparing in patients without sural-sparing on the initial study. Finally, by studying the median and radial sensory nerve action potentials at digit I in GBS patients, we demonstrate that the likely pathology of sural-sparing is related to the predilection of median nerve for subclinical entrapment; where the blood-nerve barrier is deficient and therefore more exposed to the immunopathology of GBS. Conclusion: Incorporating sural-sparing would improve the specificity of GBS electrodiagnosis; especially in difficult to diagnose regional subtypes of GBS. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V.) |
| Databáze: | MEDLINE |
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