Highlights
- •The effect of nerve conduction study timing is uncertain in Guillain–Barré syndrome.
- •This study compares early versus late electrophysiology using 2 sets of criteria.
- •No differences in subtype proportions were found with early compared to late studies.
- •Use of either sets of criteria produced similar comparative results as regards timing.
Abstract
The effect of timing is uncertain on the electrophysiology of Guillain–Barré syndrome
(GBS). On this may however depend the usefulness of systematic serial studies performed
at specific time intervals. We retrospectively analyzed records of 118 consecutive
patients with GBS from Birmingham, U.K. (2001–2012), studied between 0–14 days, or, 15–42 days post-onset using new criteria which we recently proposed [4]. Rates of acute
inflammatory demyelinating polyneuropathy (AIDP) (p = 0.45), axonal GBS (p = 0.32) and equivocal forms (p = 0.46) were similar for both timings. Similarly, no significant differences between
timings were observed using Hadden et al.'s criteria. Proportions were comparable
to published serial studies for both timings, for AIDP (p = 0.25; p = 0.10) and axonal GBS (p = 0.73; p = 0.56) but were higher than with serial studies for equivocal forms in patients studied
on days 0–14 (p = 0.012), although not in those studied on days 15–42 (p = 0.17). This suggests that over the initial 6 weeks post-onset, timing fails to influence subtype proportions in a large GBS cohort,
irrespective of criteria used. Repeat studies appear therefore unlikely to be helpful
when systematically performed within this time frame, except in equivocal cases. The
benefit of repeat studies remains possible at other times but may need to be individualized,
and requires future prospective evaluation.
Keywords
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References
- Pitfalls in electrodiagnosis of Guillain–Barré syndrome subtypes.J. Neurol. Neurosurg. Psychiatry. 2010; 81: 1157-1163
- Two sets of nerve conduction studies may suffice in reaching a reliable electrodiagnosis in Guillain–Barré syndrome.Clin. Neurophysiol. 2013; 124: 1456-1459
- Electrophysiological classification of Guillain–Barré syndrome: clinical associations and outcome.Ann. Neurol. 1998; 44: 780-788
- Electrophysiological diagnosis of Guillain–Barré syndrome subtype: could a single study suffice?.J. Neurol. Neurosurg. Psychiatry. 2015; 86: 115-119
- Electrodiagnostic criteria for acute and chronic inflammatory demyelinating polyradiculoneuropathy.Muscle Nerve. 2004; 29: 565-574
- Validity of diagnostic criteria for chronic inflammatory demyelinating polyneuropathy: a multicentre European study.J. Neurol. Neurosurg. Psychiatry. 2009; 80: 1364-1368
- Comparison of sensitivity and specificity among 15 criteria for chronic inflammatory demyelinating polyneuropathy.Muscle Nerve. 2014; 50: 40-46
- Yuki N for the GBS classification group.Nat. Rev. Neurol. 2014; 10: 537-544
- Electrodiagnosis of GBS subtypes by a single study: not yet the squaring of the circle.J. Neurol. Neurosurg. Psychiatry. 2015; 86: 5-8
Article info
Publication history
Published online: July 14, 2015
Accepted:
July 10,
2015
Received in revised form:
July 7,
2015
Received:
May 7,
2015
Footnotes
☆Funding: None.
Identification
Copyright
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
