Depts. of Clinical Neurophysiology, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Laboratory of Gut-Brain Signaling, Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, (icddr,b), Dhaka, Bangladesh.
Muscle Nerve. 2021 Apr;63(4):546-552. doi: 10.1002/mus.27172. Epub 2021 Feb 2.
The most common subtypes of Guillain-Barré syndrome (GBS) are acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN). In the first days after the onset of weakness, standard nerve conduction studies (NCS) may not distinguish GBS subtypes. Reduced nerve excitability may be an early symptom of nerve dysfunction, which can be determined with the compound muscle action potential (CMAP) scan. The aim of this study was to explore whether early changes in motor nerve excitability in GBS patients are related to various subtypes.
Prospective case-control study in 19 GBS patients from The Netherlands and 22 from Bangladesh. CMAP scans were performed within 2 days of hospital admission and NCS 7-14 days after onset of weakness. CMAP scans were also performed in age- and country-matched controls.
CMAP scan patterns of patients who were classified as AMAN were distinctly different compared to the CMAP scan patterns of the patients who were classified as AIDP. The most pronounced differences were found in the stimulus intensity parameters.
CMAP scans made at hospital admission demonstrate several characteristics that can be used as an early indicator of GBS subtype.
吉兰-巴雷综合征（GBS）最常见的亚型是急性炎症性脱髓鞘性多发性神经病（AIDP）和急性运动轴索性神经病（AMAN）。在肌无力发病后的最初几天，标准的神经传导研究（NCS）可能无法区分 GBS 亚型。神经兴奋性降低可能是神经功能障碍的早期症状，可以通过复合肌肉动作电位（CMAP）扫描来确定。本研究旨在探讨 GBS 患者运动神经兴奋性的早期变化是否与各种亚型有关。
在荷兰的 19 名 GBS 患者和孟加拉国的 22 名 GBS 患者中进行前瞻性病例对照研究。CMAP 扫描在入院后 2 天内进行，NCS 在肌无力发病后 7-14 天进行。CMAP 扫描也在年龄和国家匹配的对照组中进行。
根据 AMAN 分类的患者的 CMAP 扫描模式与根据 AIDP 分类的患者的 CMAP 扫描模式明显不同。刺激强度参数的差异最为显著。
入院时进行的 CMAP 扫描显示出一些特征，可作为 GBS 亚型的早期指标。
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