O-3-1. Sequential electrodiagnosis can contribute to differentiating subtypes of Guillain-Barré syndrome

Abstract

Guillain-Barre syndrome (GBS) is divided into two subtypes, which are acute motor axonal neuropathy (AMAN) and acute inflammatory demyelinating polyneuropathy (AIDP), and anti-ganglioside antibodies are considered to be strongly associated with axonal form of GBS. To differentiate subtypes of GBS exactly, utility of sequential electrodiagnosis has been proposed. This is a prospective multi-center study, which was conducted as a part of JET-GBS (Japanese Eculizumab Trial for GBS). To investigate validation of sequential electrodiagnosis for GBS, nerve conduction study (NCS) was conducted twice. First assessment was conducted at within two weeks from onset (first electrodiagnosis). Second assessment was conducted at four weeks later from first assessment, and diagnosis was made by considering sequential changes of NCS findings (sequential electrodiagnosis). Anti-ganglioside antibodies were measured by ELISA. We evaluated the correlation between electrodiagnosis and anti-ganglioside antibody. Thirsty-three patients were analyzed. Although antibody-positive patients were 65% in AMAN and 38% in AIDP at first electrodiagnosis (P = 0.27), sequential electrodiagnosis showed 74% of antibody-positive patients in AMAN and 15% of those in AIDP (P = 0.003). The correlation between electrodiagnosis and anti-ganglioside antibody were increased by sequential electrodiagnosis, which suggests that sequential electrodiagnosis can contribute to differentiating subtype of GBS.