Blink Reflex Value in the Early Diagnosis of Guillain-Barre Syndrome

Abstract

Introduction: Guillain Barre Syndrome (GBS) is an autoimmunemediated demyelinating or axonal polyradiculoneuropathy characterized by progressive ascending weakness plus areflexia. Three major subtypes are demyelinating, Axonal, and Miller-Fisher Syndrome. The hallmark of the definitive diagnosis of GBS is an electrodiagnostic study. The current study is aimed to assess the value of the blink reflex, as part of an electrodiagnostic study, in the diagnosis of GBS. Methods: The current census cross-sectional study has been conducted on 55 patients with the definitive diagnosis of GBS based on clinical and electrodiagnostic manifestations from January 2018 to February 2020 in Isfahan, Iran. The patients were categorized into three groups of demyelinated, axonal, and Miller-Fisher variants and blink reflex entities, including R1, R2i, and R2c were assessed for them. All data were analyzed by independent T-test paired T-test and Chi-square tests. Results: R1 was abnormal in R1 was abnormal in 17 (30.90%), R2i in two patients (3.63%), and R2c in two patients (3.63%). Among the studied patients, five (8.47%) had abnormal latency in R1, five (8.47%) in R2i, and five (8.47%) in R2c. The comparison of abnormality in blink reflex entities among diverse subtypes, including axonal, demyelinating, and Miller-Fisher variants, revealed no significant differences (P-value>0.05). Conclusion: At least one of the blink reflex indices was abnormal in up to 30.90% of the patients, it seems that the blinking reflex cannot be considered a reliable early diagnostic test for GBS, but this fact cannot completely rule out this method and additional studies should be done with more patients in other populations.