Early Electrophysiology in Suspected Acute Guillain–Barré Syndrome: A Prospective Study of Comprehensive Testing

Loading...
Thumbnail Image
Files
Winkel10283412.pdf
Embargoed until 2025-09-26
File version

Accepted Manuscript (AM)

Author(s)
Winkel, Antony
Sanders, Lauren
Seiderer, Linda
Cook, Mark
Roberts, Leslie
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
2024
Size
File type(s)
Location
License
Abstract

Purpose: Electrophysiologic changes in early Guillain–Barré Syndrome (GBS) can be nondiagnostic. Improved testing paradigms may improve hyperacute treatment.

Methods: This work prospectively evaluated consecutive patients admitted to a metropolitan teaching hospital in Melbourne, Australia, with suspected acute GBS. We performed extensive neurophysiology at three different time points. Novel tests, including cutaneous silent periods, long latency reflexes, and contraction-induced H reflexes, were assessed.

Results: Twenty-three participants were studied, including 13 cases of acute GBS. In total, 69% of acute cases of GBS were accurately diagnosed on the first nerve conduction study using published neurophysiologic criteria, with serial studies rarely altering the GBS subtype classification. Antidromic and orthodromic upper limb sensory studies were diagnostically equivalent. A sural sparing pattern was seen in 77% of cases of GBS at the first test. Long latency reflexes and contraction-induced H reflexes testing were abnormal in most participants but were limited by muscle weakness in some. Cutaneous silent periods testing was unobtainable in approximately 50% of cases because of weakness and did not discriminate from mimic disorders.

Conclusions: Abnormalities of long latency reflexes and contraction-induced H reflexes may be helpful where initial electrophysiology is nondiagnostic but are nonspecific. Cutaneous silent periods testing seems of limited value. Comprehensive testing provides diagnostic certainty in most cases of GBS from the very first study.

Journal Title

Journal of Clinical Neurophysiology

Conference Title
Book Title
Edition
Volume
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement

This work is covered by copyright. You must assume that re-use is limited to personal use and that permission from the copyright owner must be obtained for all other uses. If the document is available under a specified licence, refer to the licence for details of permitted re-use. If you believe that this work infringes copyright please make a copyright takedown request using the form at https://www.griffith.edu.au/copyright-matters.

Item Access Status
Note

This publication has been entered in Griffith Research Online as an advance online version.

Access the data
Related item(s)
Subject
Persistent link to this record
Citation

Winkel, A; Sanders, L; Seiderer, L; Cook, M; Roberts, L, Early Electrophysiology in Suspected Acute Guillain–Barré Syndrome: A Prospective Study of Comprehensive Testing, Journal of Clinical Neurophysiology, 2024

Collections