Serial electrophysiology in Guillain-Barré syndrome: A retrospective cohort and case-by-case multicentre analysis

J. Ibrahim, A. M. Grapperon, F. Manfredonia, P. Y. van den Bergh, S. Attarian, Y. A. Rajabally*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objectives: To assess the usefulness of serial electrophysiology in Guillain-Barré syndrome (GBS) in a multicenter setting and the reasons for change in electrodiagnostic subtypes with serial studies. Methods: We retrospectively analysed serial electrophysiology of 51 patients with GBS from 4 European centres. Proportions of subtypes were determined at each timing. Individual case analyses were also performed where diagnostic changes occurred with either criteria, to ascertain if changes were due to disease progression or criteria inadequacy. Results: At first study, comparing old vs new criteria, acute inflammatory demyelinating polyneuropathy (AIDP) was diagnosed in 70.6% vs 51%, axonal GBS in 15.7% vs 39.2%, equivocal forms in 11.8% vs 7.8%. At second study, AIDP was diagnosed in 72.5% vs 52.9%, axonal GBS in 9.8% vs 33.3%, equivocal forms in 15.7% vs 11.7%. Subtype proportions were unchanged, indicating serial studies did not, in the cohort, alter diagnostic rates for each subtype irrespective of criteria used. Individual review of cases where subtype electrodiagnosis changed indicated suboptimal specificity for AIDP/sensitivity for axonal GBS as main cause of diagnostic shifts with old criteria, whereas disease progression explained most changes with new criteria (55.6% vs 81.8%; P = .039). Conclusions: Serial electrophysiology is unhelpful in GBS. Repeat studies cannot represent the gold standard as electrodiagnosis may alter due to disease progression. Changes in electrodiagnosis relate more often to disease progression with new criteria but are more frequently due to suboptimal sensitivity/specificity with old criteria. A single electrophysiological study using the most accurate available criteria appears sufficient in GBS.

Original languageEnglish
JournalActa Neurologica Scandinavica
Early online date21 Nov 2017
DOIs
Publication statusPublished - 21 Nov 2017

Bibliographical note

Copyright © 2017 by John Wiley & Sons. This is the peer reviewed version of the following article: [Serial electrophysiology in Guillain-Barré syndrome: A retrospective cohort and case-by-case multicentre analysis
Ibrahim, J., Grapperon, A. M., Manfredonia, F., van den Bergh, P. Y., Attarian, S. & Rajabally, Y. A. 21 Nov 2017 In : Acta Neurologica Scandinavica.], which has been published in final form at [http://doi.org/10.1111/ane.12872]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

Keywords

  • Acute inflammatory demyelinating polyneuropathy
  • Axonal
  • Electrophysiology
  • Equivocal
  • Guillain-Barré syndrome
  • Serial
  • Single

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