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

Autor: Lee HS; Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea., Suh BC; Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea., Kim JK; Department of Neurology, Dong-A University College of Medicine, Busan, Korea., Kim BJ; Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea., Nam TS; Department of Neurology, Chonnam National University Hwasun Hospital, Gwangju, Korea., Oh J; Department of Neurology, Konkuk University College of Medicine, Seoul, Korea., Bae JS; Department of Neurology, Hallym University College of Medicine, Seoul, Korea., Shin KJ; Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea; and., Kim SW; Department of Neurology, Yonsei University College of Medicine, Seoul, Korea., Kim SM; Department of Neurology, Yonsei University College of Medicine, Seoul, Korea., Shin HY; Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Jazyk: angličtina
Zdroj: Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society [J Clin Neurophysiol] 2024 Mar 01; Vol. 41 (3), pp. 278-284. Date of Electronic Publication: 2022 Dec 02.
DOI: 10.1097/WNP.0000000000000985
Abstrakt: Purpose: Nerve conduction study (NCS) is essential for subclassifying Guillain-Barré syndrome (GBS). It is well known that the GBS subclassification can change through serial NCSs. However, the usefulness of serial NCSs is debatable, especially in patients with early stage GBS.
Methods: Follow-up NCS data within 3 weeks (early followed NCS, EFN) and within 3 to 10 weeks (late-followed NCS, LFN) were collected from 60 patients with GBS who underwent their first NCS (FN) within 10 days after symptom onset. Each NCS was classified into five subtypes (normal, demyelinating, axonal, inexcitable, and equivocal), according to Hadden's and Rajabally's criteria. We analyzed the frequency of significant changes in classification (SCCs) comprising electrodiagnostic aggravation and subtype shifts between demyelinating and axonal types according to follow-up timing.
Results: Between FN and EFN, 33.3% of patients with Hadden's criteria and 18.3% with Rajabally's criteria showed SCCs. Between FN and LFN, 23.3% of patients with Hadden's criteria and 21.7% with Rajabally's criteria showed SCCs, of which 71.4% (Hadden's criteria) and 46.2% (Rajabally's criteria) already showed SCCs from the EFN. The conditions of delayed SCCs between EFN and LFN were very early FN, mild symptoms at the FN, or persistent electrophysiological deterioration 3 weeks after symptom onset.
Conclusions: A substantial proportion of patients with GBS showed significant changes in neurophysiological classification at the early stage. Serial NCS may be helpful for precise neurophysiological classification. This study suggests that follow-up NCSs should be performed within 3 weeks of symptom onset in patients with GBS in whom FN was performed within 10 days of symptom onset.
Competing Interests: The authors have no funding or conflicts of interest to disclose.
(Copyright © 2022 by the American Clinical Neurophysiology Society.)
Databáze: MEDLINE