Abstract
Guillain-Barré syndrome can present as demyelinating or axonal subtypes. Recent studies
suggest that the neurophysiology of the axonal subtype not only exhibits axonal degeneration
but can also show reversible conduction failure at the early stages. It is less certain
if reversible conduction failure is evident in only a minority of patients with a
specific subtype associated with better prognosis. We describe a 73-year-old man with
Guillain-Barré syndrome and electrodiagnostic features of both reversible conduction
block and possible axonal degeneration. Initial features of conduction failure were
seen in both median nerves. This was followed by features of axonal degeneration,
with corresponding weakness in the left abductor pollicis brevis and lumbricalis muscles,
which are innervated by the median nerve, but rapid resolution of conduction block
with corresponding rapid clinical recovery in the right. The presence of both features
in a single patient provides further evidence that early conduction failure can be
followed by either rapid resolution or axonal degeneration in the electrophysiological
spectrum of axonal Guillain-Barré syndrome.
Keywords
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Article info
Publication history
Published online: June 04, 2012
Accepted:
May 1,
2012
Received in revised form:
April 21,
2012
Received:
February 23,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.