Background: The diagnostic yield of various neurophysiological criteria may vary in different subforms of Guillain Barre syndrome (GBS), whose prevalence varies in different geographical areas.
Aims: To evaluate the sensitivity of various neurophysiological criteria in different clinical subtypes of GBS, and their relationship with severity, duration and outcome.
Methods: Consecutive GBS patients were subjected to detailed clinical evaluation. Severity was graded on a 0-10scale. Motor and sensory nerve conductions and F wave studies were done. The diagnostic sensitivity of Albers et al (set1), Cornblath (set2), Ho et al (set 3), Dutch GBS study group (set 4), Italian GBS study group (set 5) and Albers and Kelly (set 6) criteria were evaluated and correlated with clinical subtypes of GBS, duration, severity and outcome.
Results: There were 51 patients. Mean disability was 6.8; 34 patients were bedridden and 5 needed ventilator. Clinical presentation was pure motor in 31, motorsensory in 18 and pure sensory in 2 patients. The sensitivity of nerve conduction study (NCS) in the diagnosis of GBS was highest in set 1 (88.2%) followed by set 3 (86.3%) and set 4 (82.4%) and lowest in set 2 (39.2%). The diagnostic yield of set1, 3 and 4 were also higher than set 2, 5 and 6 in different clinical subtypes of GBS. As per Ho et al, patients could be categorized into AIDP in 44 (86.3%), AMAN in 4 (7.8%) and AMSAN in 3 (5.9%). One (2%) patient died, 22.4% had complete, 57.1% partial and 18.4% poor recovery at 3months. Outcome was related to severity of illness and CMAP (compound muscle action potential) amplitude.
Conclusion: The sensitivity of different neurophysiological criteria in the diagnosis of Indian GBS patients varied from 39.2% to 88.2%. The outcome was related to severity of illness and CMAP amplitude.
- GB Syndrome
- Nerve conduction study
- Neurophysiological criteria