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

被引:0
作者
Lee, Hyung-Soo [1 ]
Suh, Bum Chun [2 ]
Kim, Jong Kuk [3 ]
Kim, Byung-Jo [4 ]
Nam, Tai-Seung [5 ]
Oh, Jeeyoung [6 ]
Bae, Jong Seok [7 ]
Shin, Kyong Jin [8 ]
Kim, Seung Woo [9 ]
Kim, Seung Min [9 ]
Shin, Ha Young [9 ,10 ]
机构
[1] Korea Univ, Coll Med, Dept Neurol, Ansan Hosp, Ansan, South Korea
[2] Sungkyunkwan Univ, Sch Med, Kangbuk Samsung Hosp, Dept Neurol, Seoul, South Korea
[3] Dong A Univ, Coll Med, Dept Neurol, Busan, South Korea
[4] Korea Univ, Anam Hosp, Dept Neurol, Coll Med, Seoul, South Korea
[5] Chonnam Natl Univ, Hwasun Hosp, Dept Neurol, Gwangju, South Korea
[6] Konkuk Univ, Dept Neurol, Coll Med, Seoul, South Korea
[7] Hallym Univ, Coll Med, Dept Neurol, Seoul, South Korea
[8] Inje Univ, Coll Med, Haeundae Paik Hosp, Dept Neurol, Busan, South Korea
[9] Yonsei Univ, Dept Neurol, Coll Med, Seoul, South Korea
[10] Yonsei Univ, Coll Med, Dept Neurol, 50-1 Yonsei Ro, Seoul 03722, South Korea
关键词
Guillain-Barre syndrome; Nerve conduction studies; Acute inflammatory demyelinating polyneuropathy; Acute motor axonal neuropathy; Serial nerve conduction study; EARLY ELECTRODIAGNOSTIC FINDINGS; SYNDROME SUBTYPES; PATTERNS; CRITERIA; FAILURE; BLOCK; SETS;
D O I
10.1097/WNP.0000000000000985
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Supplemental Digital Content is Available in the Text. Purpose:Nerve conduction study (NCS) is essential for subclassifying Guillain-Barre 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.
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收藏
页码:278 / 284
页数:7
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