P236 Electrophysiological assessment of Guillain–Barre subtypes in a sample of IRAQI children

Abstract

Objectives Assess the role of neurophysiological study (EMG and NCS) in the diagnosis of Guillain-Barre syndrome subtypes in children and estimate the frequency of subtypes whether demyelinating or axonal. Methods Two study groups of either sex were involved, (thirty) Guillain-Barre patients with different ages and (thirty) healthy subjects matched for age and gender served as control group. Each subject submitted to sensory and motor nerve conduction study (NCS) and electromyography (EMG) of both upper and lower limbs. Results Results revealed that (80%), (16.7%), (3.3%) of children had acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN) and acute motor sensory axonal neuropathy (AMSAN) respectively. The H-reflex was absent in (73.3%) of patients. Discussion In this study AIDP was the most frequent type of GBS followed by AMAN then AMSAN, similarly a study from Iran reported that AIDP was the most frequent type among children, suggesting that; the incidence of AIDP in GBS differs geographically. H-reflex was absent in the majority (73.3%) of children, and this was lower than Gordon P.2001 where the absence of H-reflex was 97%, because of early time of examination. Conclusion Acute inflammatory demyelinating polyneuropathy (AIDP) is the most frequent subtype of GBS, the change in sensory and motor NCS parameters was higher in lower limbs than upper limbs. Proximal segments are more vulnerable to demyelination rather than intermediate or distal nerve segments. Significance The subtype differentiation is essential for the neurologist and the patient’s parents in identifying the recovery period.