Electrophysiological study of Guillain–Barre Syndrome (GBS) patients in Amravati region.

Dr. Savita M Wawge; Dr. Vrushali R Parate; Dr. A V Daphale; Dr. Sushma S Pande

Volume : IX, Issue : V, May - 2019

Electrophysiological study of Guillain–Barre Syndrome (GBS) patients in Amravati region.

Dr. Savita M Wawge, Dr. Vrushali R Parate, Dr. A V Daphale, Dr. Sushma S Pande

Abstract :

Background: Guillain–Barré Syndrome (GBS) is acute, frequently severe, fulminant polyneuropathy. Electrophysiology has emerged as important tool for early diagnosis and identifying various subtypes of GBS. Objective: To assess motor and sensory nerve conduction parameters in early course of disease and to classify the patients in various subtypes of GBS using electrodiagnostic (Edx) criteria. Material and methods: We retrospectively evaluated Edx data of 23 clinically diagnosed cases of GBS presented within 2 weeks of onset of muscle weakness. Nerve conduction studies were done in six motor nerves (Median, ulnar & tibial bilaterally) and six sensory nerves (median, ulnar & sural bilaterally) in each case. Results: Abnormal F wave was seen in 94.20% nerves tested. Other early nerve conduction findings included prolonged distal motor latencies (DML) in 77.54%, Compound Motor Action Potential (CMAP) reduction in 63.04% and Conduction Velocity (CV) reduction in 34.05% of nerves tested. Abnormal Sensory Nerve Action Potentials (SNAPs) were present in 45.65% of nerves tested. 20 cases (86.96%) were identified as Acute Inflammatory Demyelinating Polyneuropathy (AIDP) while 03 cases (13.04%) had axonal form of disease [Acute Motor Axonal Neuropathy (AMAN) and Acute Motor Sensory Axonal Neuropathy (AMSAN)] Conclusion: The most affected motor nerve conduction (MNC) parameter was absent/delayed F wave. Increased DML & low CMAPs were other common findings. Reduced CV was less common which can be attributed to early course of the disease. The most common variant of GBS was AIDP in which early Edx marker included abnormal F– wave, increased DML and sensory conduction abnormality showing sural spå pattern