Electrodiagnostic subtyping in Guillain-Barré syndrome patients in the International Guillain-Barré Outcome Study.
Journal
European journal of neurology
Journal Volume
31
Journal Issue
9
Start Page
e16335
ISSN
1468-1331
Date Issued
2024-09
Author(s)
Arends, Samuel
Drenthen, Judith
de Koning, Laura
van den Bergh, Peter
Hadden, Robert D M
Kuwabara, Satoshi
Reisin, Ricardo C
Shahrizaila, Nortina
Ajroud-Driss, Senda
Antonini, Giovanni
Attarian, Shahram
Balducci, Claudia
Bertorini, Tulio
Brannagan, Thomas H
Cavaletti, Guido
Chao, Chi-Chao
Chavada, Govind
Dillmann, Klaus-Ulrich
Dimachkie, Mazen M
Galassi, Giuliana
Gutiérrez-Gutiérrez, Gerardo
Harbo, Thomas
Islam, Badrul
Islam, Zhahirul
Katzberg, Hans
Kusunoki, Susumu
Manganelli, Fiore
Miller, James A L
Pardo, Julio
Pereon, Yann
Rajabally, Yusuf A
Sindrup, Soren
Stettner, Mark
Uncini, Antonino
Verhamme, Camiel
Vytopil, Michal
Waheed, Waqar
Jacobs, Bart C
Cornblath, David R
Abstract
Various electrodiagnostic criteria have been developed in Guillain–Barré syndrome (GBS). Their performance in a broad representation of GBS patients has not been evaluated. Motor conduction data from the International GBS Outcome Study (IGOS) cohort were used to compare two widely used criterion sets and relate these to diagnostic amyotrophic lateral sclerosis criteria. Methods: From the first 1500 patients in IGOS, nerve conduction studies from 1137 (75.8%) were available for the current study. These patients were classified according to nerve conduction studies criteria proposed by Hadden and Rajabally. Results: Of the 1137 studies, 68.3% (N = 777) were classified identically according to criteria by Hadden and Rajabally: 111 (9.8%) axonal, 366 (32.2%) demyelinating, 195 (17.2%) equivocal, 35 (3.1%) inexcitable and 70 (6.2%) normal. Thus, 360 studies (31.7%) were classified differently. The areas of differences were as follows: 155 studies (13.6%) classified as demyelinating by Hadden and axonal by Rajabally; 122 studies (10.7%) classified as demyelinating by Hadden and equivocal by Rajabally; and 75 studies (6.6%) classified as equivocal by Hadden and axonal by Rajabally. Due to more strictly defined cutoffs fewer patients fulfilled demyelinating criteria by Rajabally than by Hadden, making more patients eligible for axonal or equivocal classification by Rajabally. In 234 (68.6%) axonal studies by Rajabally the revised El Escorial (amyotrophic lateral sclerosis) criteria were fulfilled; in axonal cases by Hadden this was 1.8%. Conclusions and discussion: This study shows that electrodiagnosis in GBS is dependent on the criterion set utilized, both of which are based on expert opinion. Reappraisal of electrodiagnostic subtyping in GBS is warranted.
Subjects
Guillain–Barré syndrome
amyotrophic lateral sclerosis
electrodiagnosis
nerve conduction studies
polyneuropathy
SDGs
Type
journal article