Neuromuscular Unit, Neurology Department, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain.
J Peripher Nerv Syst. 2011 Jun;16(2):136-42. doi: 10.1111/j.1529-8027.2011.00338.x.
Electrodiagnostic studies play a key role in the evaluation of patients with Guillain-Barré syndrome (GBS). However, at early stages patients may not meet current neurophysiologic criteria. We report electrodiagnostic findings for 18 patients with suspected GBS within 4 days of clinical onset. Fifteen patients (83%) showed abnormality in the motor nerve conduction study. Prolonged distal motor latency (DML) was the most frequent demyelinating parameter (seen in 55% of patients). Abnormal late responses were noted in 14 patients (77%). Electrodiagnostic study of cranial nerves was abnormal in eight (44%), and motor nerve conduction velocity was abnormal in only six patients (23%). The study shows a predominant motor neuropathy pattern followed by a sural-sparing pattern; no patients showed a strictly normal electrodiagnostic study. Reduced distal compound muscle action potential and prolonged DML in the demyelinating range were associated with severity of GBS on admission. After the electrodiagnostic study, 5 patients (27%) already fulfilled electrodiagnostic criteria for acute inflammatory demyelinating polyneuropathy (AIDP), 1 (5%) for the axonal variant of GBS, and 13 (72%) were classified as equivocal. We conclude that exhaustive electrodiagnostic studies of patients with suspected GBS in very early stages are useful in the diagnosis and management of the condition.
电诊断研究在评估格林-巴利综合征（GBS）患者中起着关键作用。然而，在早期阶段，患者可能不符合当前的神经生理标准。我们报告了 18 例在临床发病后 4 天内疑似 GBS 的患者的电诊断结果。15 例患者（83%）的运动神经传导研究异常。最长的远端运动潜伏期（DML）是最常见的脱髓鞘参数（见于 55%的患者）。14 例患者（77%）出现异常晚反应。8 例（44%）颅神经电诊断异常，仅 6 例（23%）运动神经传导速度异常。研究显示以运动神经病为主，随后出现腓肠神经保留模式；没有患者表现出完全正常的电诊断。入院时，GBS 严重程度与远端复合肌肉动作电位降低和脱髓鞘范围内的 DML 延长相关。电诊断研究后，5 例（27%）患者已符合急性炎症性脱髓鞘性多发性神经病（AIDP）的电诊断标准，1 例（5%）符合 GBS 的轴索性变异，13 例（72%）为疑似。我们的结论是，对早期疑似 GBS 的患者进行全面的电诊断研究有助于该疾病的诊断和管理。
