Département de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Département de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Clin Neurophysiol. 2014 Sep;125(9):1900-5. doi: 10.1016/j.clinph.2014.01.007. Epub 2014 Jan 27.
Although patients with acute inflammatory demyelinating polyneuropathy (AIDP) are frequently admitted a few days after symptoms onset, electrodiagnostic (EDX) abnormalities in early AIDP are not well characterized. Our aim was to determine the EDX pattern of early AIDP, and, if needed, to propose new EDX diagnostic criteria.
In this monocentric study, we retrospectively reviewed the clinical and EDX data of 58 consecutive AIDP patients in whom EDX studies had been performed within 7 days after disease onset, representing 46% of all GBS patients admitted in our hospital in an 11 years interval.
EDX abnormalities were observed in all patients. The most altered parameters were H reflexes (97% of cases), motor nerve conduction velocities (78%) and distal motor latencies (78%). Only 66% of patients fulfilled the most sensitive published AIDP EDX diagnosis criteria. When using a new set of EDX criteria, which require only one marked EDX abnormality, we observed that 81% of patients could be diagnosed with AIDP.
This study suggests that exhaustive EDX studies are always abnormal in early AIDP, and that existing EDX diagnosis criteria can be improved.
Our findings are useful for the interpretation of EDX studies in early AIDP.
尽管急性炎症性脱髓鞘性多发性神经病（AIDP）患者常在症状出现后几天内住院，但早期 AIDP 的电诊断（EDX）异常尚未得到很好的描述。我们的目的是确定早期 AIDP 的 EDX 模式，如果需要，提出新的 EDX 诊断标准。
在这项单中心研究中，我们回顾性分析了 58 例连续 AIDP 患者的临床和 EDX 数据，这些患者在疾病发病后 7 天内进行了 EDX 检查，占我们医院在 11 年时间内收治的所有 GBS 患者的 46%。
所有患者均出现 EDX 异常。改变最明显的参数是 H 反射（97%的病例）、运动神经传导速度（78%）和远端运动潜伏期（78%）。只有 66%的患者符合发表的最敏感的 AIDP EDX 诊断标准。当使用新的 EDX 标准集时，仅需要一个明显的 EDX 异常，我们观察到 81%的患者可以被诊断为 AIDP。
本研究表明，在早期 AIDP 中，详尽的 EDX 研究总是异常的，并且现有的 EDX 诊断标准可以得到改进。
我们的发现有助于解释早期 AIDP 的 EDX 研究。
