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Dysfunction at the motor end‐plate and axon membrane in Guillain–Barré syndrome: A single‐fiber EMG study
Author(s) -
Spaans Frank,
Vredeveld JanWillem,
Morré Humphrey H.E.,
Jacobs Bart C.,
De Baets Marc H.
Publication year - 2003
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.10334
Subject(s) - compound muscle action potential , medicine , guillain barre syndrome , neuromuscular transmission , electromyography , jitter , acute motor axonal neuropathy , anesthesia , electrophysiology , physical medicine and rehabilitation , immunology , electronic engineering , engineering
In nine patients with Guillain‐Barré syndrome (GBS), stimulation single‐fiber electromyography (SFEMG) and serological studies were performed in the acute stage of the illness. Increased jitter and intermittent blocking of muscle fiber action potentials occurred to a varying degree in all patients. Five patients had elevated titers of antiganglioside antibodies. The most remarkable EMG phenomenon was the occurrence in all patients of impulse blocking at normal or slightly increased jitter. The assumption that this phenomenon was due to an axolemmal dysfunction was confirmed by the occurrence in two patients of concomitant blocking of two muscle fiber action potentials at strictly normal jitter values. In one patient this sign of axonal dysfunction was demonstrated with SFEMG at voluntary activation. In another patient, concomitant blocking was associated with greatly increased but completely independent jitter of both components. The results of this study show that both a disorder of neuromuscular transmission and an axolemmal dysfunction play a role in the pathophysiology of GBS. Muscle Nerve 27: 426–434, 2003