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01-09-2016 | Original Communication

Serial electrophysiological findings in Guillain–Barré syndrome not fulfilling AIDP or AMAN criteria

Authors: Takafumi Hosokawa, Hideto Nakajima, Kiichi Unoda, Kazushi Yamane, Yoshimitsu Doi, Shimon Ishida, Fumiharu Kimura, Toshiaki Hanafusa

Published in: Journal of Neurology | Issue 9/2016

Abstract

Guillain–Barré syndrome (GBS) is categorized into two major subtypes: acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN). However, a proportion of patients are electrophysiologically unclassified because of electrophysiological findings that do not fulfil AIDP or AMAN criteria, and underlying pathophysiological mechanisms and lesion distributions of unclassified patients are not well defined. The aims of this study are to elucidate disease pathophysiology and lesion distribution in unclassified patients. We retrospectively studied 48 consecutive GBS patients. Patients were classified on the basis of initial electrophysiological findings according to Ho’s criteria. Clinical and serial electrophysiological examinations of unclassified patients were conducted. Twelve (25 %) GBS patients were unclassified. All unclassified patients were able to walk independently at 21 days after onset. No unclassified patients, except one patient with diabetes mellitus, had sensory nerve involvement. Eight patients underwent a follow-up study within 15 days of the initial study. Distal motor latencies (DMLs) of the left median motor nerve were found to be significantly and uniformly decreased compared with initial studies (p = 0.008). DMLs (p < 0.0001) and distal compound action potential (CMAP) durations (p = 0.002) of all nerves were significantly decreased, and distal CMAP amplitudes (p = 0.026) significantly increased compared with initial studies. In unclassified GBS patients, DML values during initial electrophysiological studies would be prolonged compared with expected values in the same patient unaffected by GBS and later improve rapidly with increased distal CMAP amplitudes without the development of excessive temporal dispersions. Lesions are also present in distal nerve segments caused by reversible conduction failure.

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Title: Serial electrophysiological findings in Guillain–Barré syndrome not fulfilling AIDP or AMAN criteria
Authors: Takafumi Hosokawa
Hideto Nakajima
Kiichi Unoda
Kazushi Yamane
Yoshimitsu Doi
Shimon Ishida
Fumiharu Kimura
Toshiaki Hanafusa
Publication date: 01-09-2016
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 9/2016
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-016-8192-2

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Serial electrophysiological findings in Guillain–Barré syndrome not fulfilling AIDP or AMAN criteria

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