Electrodiagnostic subtyping in Guillain–Barré syndrome patients in the International Guillain–Barré Outcome Study

Samuel Arends*, Judith Drenthen, Laura de Koning, Peter van den Bergh, Robert D.M. Hadden, Satoshi Kuwabara, Ricardo C. Reisin, Nortina Shahrizaila, Senda Ajroud-Driss, Giovanni Antonini, Shahram Attarian, Claudia Balducci, Tulio Bertorini, Thomas H. Brannagan, Guido Cavaletti, Chi Chao Chao, Govind Chavada, Klaus Ulrich Dillmann, Mazen M. Dimachkie, Giuliana GalassiGerardo Gutiérrez-Gutiérrez, Thomas Harbo, Badrul Islam, Zhahirul Islam, Hans Katzberg, Susumu Kusunoki, Fiore Manganelli, James A.L. Miller, Julio Pardo, Yann Pereon, Yusuf A. Rajabally, Soren Sindrup, Mark Stettner, Antonino Uncini, Camiel Verhamme, Michal Vytopil, Waqar Waheed, Bart C. Jacobs, David R. Cornblath, the IGOS Consortium

*Corresponding author for this work

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Abstract

Background and purpose: Various electrodiagnostic criteria have been developed in Guillain–Barré syndrome (GBS). Their performance in a broad representation of GBS patients has not been evaluated. Motor conduction data from the International GBS Outcome Study (IGOS) cohort were used to compare two widely used criterion sets and relate these to diagnostic amyotrophic lateral sclerosis criteria. Methods: From the first 1500 patients in IGOS, nerve conduction studies from 1137 (75.8%) were available for the current study. These patients were classified according to nerve conduction studies criteria proposed by Hadden and Rajabally. Results: Of the 1137 studies, 68.3% (N = 777) were classified identically according to criteria by Hadden and Rajabally: 111 (9.8%) axonal, 366 (32.2%) demyelinating, 195 (17.2%) equivocal, 35 (3.1%) inexcitable and 70 (6.2%) normal. Thus, 360 studies (31.7%) were classified differently. The areas of differences were as follows: 155 studies (13.6%) classified as demyelinating by Hadden and axonal by Rajabally; 122 studies (10.7%) classified as demyelinating by Hadden and equivocal by Rajabally; and 75 studies (6.6%) classified as equivocal by Hadden and axonal by Rajabally. Due to more strictly defined cutoffs fewer patients fulfilled demyelinating criteria by Rajabally than by Hadden, making more patients eligible for axonal or equivocal classification by Rajabally. In 234 (68.6%) axonal studies by Rajabally the revised El Escorial (amyotrophic lateral sclerosis) criteria were fulfilled; in axonal cases by Hadden this was 1.8%. Conclusions and discussion: This study shows that electrodiagnosis in GBS is dependent on the criterion set utilized, both of which are based on expert opinion. Reappraisal of electrodiagnostic subtyping in GBS is warranted.

Original languageEnglish
Article numbere16335
JournalEuropean Journal of Neurology
Volume31
Issue number9
Number of pages11
ISSN1351-5101
DOIs
Publication statusPublished - Sept 2024

Keywords

  • amyotrophic lateral sclerosis
  • electrodiagnosis
  • Guillain–Barré syndrome
  • nerve conduction studies
  • polyneuropathy
  • Humans
  • Middle Aged
  • Male
  • Neural Conduction/physiology
  • Guillain-Barre Syndrome/diagnosis
  • Electrodiagnosis/methods
  • Female
  • Adult
  • Aged
  • Amyotrophic Lateral Sclerosis/diagnosis
  • Cohort Studies

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