Early Electrodiagnostic Abnormalities in Guillain-Barre Syndrome (P01.200)

Abstract

Objective: To provide data on early electrodiagnostic (EDX) abnormalities observed in early Guillain-Barre syndrome (GBS). Background GBS is a potentially life-threatening affection requiring early diagnosis and treatment. In this context, relevant EDX criteria are required for the early diagnosis of GBS. Design/Methods: We retrospectively reviewed the clinical and EDX data of GBS patients investigated in our department in whom EDX studies had been performed 7 days or less after the onset of clinical signs. Patients with a previously known polyneuropathy or a condition such as diabetes, alcoholism, and chronic kidney disease, were excluded. Motor nerve conduction velocities (MNCV), sensory nerve conduction velocities (SNCV), distal motor latencies (DML), sensory nerve action potential (SNAP) amplitudes, compound muscle action potential (CMAP) amplitudes, H reflexes, F waves, conduction block and temporal dispersion were investigated in all patients. Results: Forty patients were included in our study. Ninety-two percents of patients had abnormal H reflexes, 77% had slowed MNCV, 67% had delayed DML, 61% had abnormal F waves, 52% had reduced CMAP amplitude, and 50% had reduced SNAP amplitude. Conduction blocks were observed in 42% of patients, and temporal dispersion in 30%. When combining all EDX parameters, abnormalities were observed in 97% of patients with early GBS. Conclusions: Exhaustive EDX studies in patients with GBS at the early stage are crucial for diagnosis and management of this condition. The H reflex is the most sensitive test for early GBS, followed by slowed MNCV, delayed DML, and abnormal F waves. Disclosure: Dr. Chanson has nothing to disclose. Dr. De Seze has received personal compensation for activities with Bayer Schering, Biogen Idec, LFB, Merck Serono, Novartis, Sanofi-Aventis, and Teva Neuroscience.Dr. De Seze has received personal compensation in an editorial capacity for Elsevier. Dr. Echaniz-Laguna has nothing to disclose.