Electrodiagnostic criteria for Guillain–Barrè syndrome: A critical revision and the need for an update

@article{Uncini2012ElectrodiagnosticCF,
  title={Electrodiagnostic criteria for Guillain–Barr{\`e} syndrome: A critical revision and the need for an update},
  author={Antonino Uncini and Satoshi Kuwabara},
  journal={Clinical Neurophysiology},
  year={2012},
  volume={123},
  pages={1487-1495}
}

Figures and Tables from this paper

Electrodiagnosis of GBS subtypes by a single study: not yet the squaring of the circle
TLDR
The lack of distinction between RCF and demyelinating conduction block leads to fallaciously classify AMAN patients with RCF as AIDP or, in presence of reduced distal compound muscle action potentials (CMAP), as AMAN with axonal degeneration and erroneously formulate a poor prognosis.
Timing is crucial for electrodiagnosis of Guillain-Barré syndrome
We read the paper by Rajabally et al 1 with interest. Two major subtypes of Guillain-Barre syndrome (GBS), namely axonal (acute motor axonal neuropathy and acute motor-sensory axonal neuropathy) and
Guillain‐BarrÉ syndrome subtype diagnosis: A prospective multicentric European study
TLDR
The absence of exclusive correlation with RCF and anti‐ganglioside antibodies may challenge the concept of demyelinating and axonal GBS subtypes based upon electrophysiological criteria.
Towards international agreement on criteria for Guillain-Barré syndrome
Electrodiagnosis of reversible conduction failure in Guillain–Barré syndrome
TLDR
Electrodiagnostic criteria for early reversible conduction failure (ERCF) in axonal Guillain–Barré syndrome (GBS) are applied and a group of patients are identified with a characteristic evolution of NCS abnormality that is consistent with ERCF.
Early discrimination of sensorimotor Guillain‐Barré syndrome into demyelinating or axonal subtype by automated nerve excitability testing
TLDR
This study identified that both AIDP and AMSAN were associated with subtle changes in excitability properties, and the prominent increase in refractoriness in AMSAN suggests the presence of a nodal conduction block.
Proximal nerve lesions in early Guillain–Barré syndrome: implications for pathogenesis and disease classification
TLDR
The aim of this paper was to analyze the nosology of early GBS reviewing electrophysiological, autopsy and imaging studies, both in acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor/motor-sensory axonal neuropathy (AMAN/AMSAN).
99 years of Guillain–Barré syndrome: pathophysiological insights from neurophysiology
  • A. Uncini
  • Biology, Medicine
    Practical Neurology
  • 2015
TLDR
The wide heterogeneity of the clinical spectrum of Guillain–Barre syndrome is reported, highlighting atypical presentations and reviewing the differential diagnoses, to facilitate early diagnosis and treatment without relying on laboratory and electrophysiological findings.
Electrophysiological diagnosis of Guillain–Barré syndrome subtype: could a single study suffice?
TLDR
A single electrophysiological study may suffice to establish the ultimate electrodiagnosis of GBS subtype if the proposed modified electrodiagnostic criteria are used.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 76 REFERENCES
Electrophysiological studies in the Guillain–Barré syndrome: Distinguishing subtypes by published criteria
TLDR
In a single well‐defined GBS population, the number of patients categorized as having AIDP ranged from 21% to 72%.
Pitfalls in electrodiagnosis of Guillain–Barré syndrome subtypes
TLDR
Investigation of how serial recordings changed the classification of an Italian Guillain–Barré syndrome population into demyelinating and axonal subtypes found that axonal GBS is pathophysiologically characterised not only by axonal degeneration but also by reversible conduction failure at the axolemma of the Ranvier node.
Electrophysiologic and immunopathologic correlates in Guillain–Barré syndrome subtypes
TLDR
Serial electrophysiologic studies are mandatory for identification of GBS subtypes and to elucidate the pathophysiologic mechanisms of muscle weakness among demyelination, axonal degeneration and physiologic conduction block.
Patterns and serial changes in electrodiagnostic abnormalities of axonal Guillain–Barré syndrome
TLDR
Besides the simple axonal degeneration pattern, patients with anti-ganglioside-positive Guillain–Barré syndrome can show transient conduction slowing/block in the distal or proximal nerve segments, mimicking demyelination, but anti- Gangliosides antibodies do not appear to be associated with acute inflammatory demYelinating polyneuropathy.
Electrophysiological classification of guillain‐barré syndrome: Clinical associations and outcome
TLDR
Patients with pure motor GBS, enrolled in a trial comparing plasma exchange, intravenous immunoglobulin, and both treatments, were more likely than other GBS patients to have IgG antiganglioside GM1 antibodies and to have had preceding diarrhea but had a similar outcome.
IgG Anti‐GM1 antibody is associated with reversible conduction failure and axonal degeneration in guillain‐barré syndrome
TLDR
Rapid resolution of conduction slowing and block, and the absence of remyelinating slow components, suggest that conduction failure may be caused by impaired physiological conduction at the nodes of Ranvier.
Guillain–Barré syndrome in Pakistan: similarity of demyelinating and axonal variants
TLDR
The characteristics of GBS cases consecutively admitted to a tertiary care hospital in Karachi, Pakistan, over a 13‐year period were reviewed, finding similarity of outcomes in axonal and demyelinating variants and lack of C. jejuni stool culture positivity.
Guillain-Barré syndrome
TLDR
Molecular mimicry of the bacterial lipo-oligosaccharide by the human gangliosides is now considered an important cause of AMAN andMeta-analyses show efficacy of plasmapheresis and immunoglobulin therapy, but not corticosteroids, in hastening recovery.
Recovery patterns and long term prognosis for axonal Guillain–Barré syndrome
TLDR
Almost all the severe AMAN patients who had slow recoveries over the first six months could eventually walk independently, although some required several years.
...
1
2
3
4
5
...