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Very early and early neurophysiological abnormalities in Guillain–Barré syndrome: A 4‐year retrospective study
Author(s) -
Rasera Andrea,
Romito Silvia,
Segatti Alessia,
Concon Elisa,
Alessandrini Luca,
Basaldella Federica,
Badari Andrea,
Bonetti Bruno,
Squintani Giovanna
Publication year - 2021
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.15011
Subject(s) - medicine , neurophysiology , guillain barre syndrome , h reflex , neurology , clinical neurophysiology , reflex , retrospective cohort study , electromyography , neurological examination , sural nerve , f wave , pediatrics , anesthesia , audiology , nerve conduction velocity , electroencephalography , surgery , physical medicine and rehabilitation , psychiatry
Abstract Background and purpose In its initial stages, Guillain–Barré syndrome (GBS) is difficult to identify, because diagnostic criteria may not always be fulfilled. With this retrospective study, we wanted to identify the most common electrophysiological abnormalities seen on neurophysiological examination of GBS patients and its variants in the early phases. Methods We reviewed the clinical records of patients admitted to our Neurology Unit with a confirmed diagnosis of GBS. The study sample was divided in two subgroups according to whether the neurophysiological examination was performed: within 7 days (very early group) or within 7–15 days (early group). H reflex, F waves, and motor and sensory conduction parameters were judged abnormal if they were outside the normal range for at least two nerves. We evaluated neurophysiological findings in Miller–Fisher syndrome (MFS) separately. Results The study sample comprised 36 patients. In GBS, the most frequent abnormal neurophysiological parameter was the bilateral absence of the H reflex, followed by F wave abnormalities. Motor conduction parameters were altered in less than 50% of patients, and even less common were sensory nerve action potential reduction and the "sural‐sparing" pattern. In MFS, H reflex was absent bilaterally in 100% of patients, followed by a predominant peripheral sensory involvement, whereas motor conduction parameters were frequently normal. Conclusions Bilateral absence of the H reflex is the most sensitive parameter in early diagnosis of GBS and its variants.