Electrodiagnostic abnormalities in 113 consecutive patients with Guillain-Barré syndrome. 1990

A H Ropper, and E F Wijdicks, and B T Shahani
Clinical Neurophysiology Laboratory, Massachusetts General Hospital, Boston 02114.

We performed electrodiagnostic tests on 113 consecutive patients with acute Guillain-Barré syndrome (103 within 3 weeks of onset). The most common motor conduction abnormalities were proximal conduction block alone (27%), proximal block associated with a distal lesion (27%), and generalized slowing (22%). Other combinations of abnormalities each occurred in fewer than 10% of patients. Thirty-seven percent of patients initially had normal sensory nerve conduction study results, most often in association with proximal conduction block. The characteristic early electrodiagnostic changes in Guillain-Barré syndrome were often present when cerebrospinal fluid protein concentration was still normal. Extensive early fibrillations occurred in 10 patients, 6 of whom recovered well. Patients with early generalized slowing of motor nerve conduction velocity, combined abnormalities, or low muscle action potential amplitudes in ulnar, median, and peroneal nerves generally, but not always, had poorer outcomes than patients with conduction block in one nerve segment. There was no consistent relationship between results of electrophysiologic studies and overall clinical grade or limb power, except that none of the patients with an isolated proximal block had virtual or complete paralysis in the same limb.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009431 Neural Conduction The propagation of the NERVE IMPULSE along the nerve away from the site of an excitation stimulus. Nerve Conduction,Conduction, Nerve,Conduction, Neural,Conductions, Nerve,Conductions, Neural,Nerve Conductions,Neural Conductions
D010525 Peripheral Nerves The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. Endoneurium,Epineurium,Perineurium,Endoneuriums,Epineuriums,Nerve, Peripheral,Nerves, Peripheral,Perineuriums,Peripheral Nerve
D011129 Polyradiculoneuropathy Diseases characterized by injury or dysfunction involving multiple peripheral nerves and nerve roots. The process may primarily affect myelin or nerve axons. Two of the more common demyelinating forms are acute inflammatory polyradiculopathy (GUILLAIN-BARRE SYNDROME) and POLYRADICULONEUROPATHY, CHRONIC INFLAMMATORY DEMYELINATING. Polyradiculoneuritis refers to inflammation of multiple peripheral nerves and spinal nerve roots. Autoimmune Demyelinating Disease, Peripheral,Demyelinating Autoimmune Disease, Peripheral,Demyelinating Disease, Peripheral Autoimmune,Peripheral Autoimmune Demyelinating Disease,Polyradiculoneuritis,Polyradiculoneuritides,Polyradiculoneuropathies
D002556 Cerebrospinal Fluid Proteins Proteins in the cerebrospinal fluid, normally albumin and globulin present in the ratio of 8 to 1. Increases in protein levels are of diagnostic value in neurological diseases. (Brain and Bannister's Clinical Neurology, 7th ed, p221) Proteins, Cerebrospinal Fluid,Fluid Proteins, Cerebrospinal
D004576 Electromyography Recording of the changes in electric potential of muscle by means of surface or needle electrodes. Electromyogram,Surface Electromyography,Electromyograms,Electromyographies,Electromyographies, Surface,Electromyography, Surface,Surface Electromyographies
D005073 Evoked Potentials, Somatosensory The electric response evoked in the CEREBRAL CORTEX by stimulation along AFFERENT PATHWAYS from PERIPHERAL NERVES to CEREBRUM. Somatosensory Evoked Potentials,Evoked Potential, Somatosensory,Somatosensory Evoked Potential
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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