Ginanneschi Federica, Cioncoloni David, Capoccitti Giorgio, Volpi Nila, Ferretti Fabio, Giannini Fabio, Rossi Alessandro
Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
U.O.P. Professioni della Riabilitazione, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Neurol Res. 2023 Apr;45(4):381-389. doi: 10.1080/01616412.2022.2148517. Epub 2022 Nov 20.
Electrophysiology plays a crucial role in Guillain-Barré syndrome (GBS) diagnosis and subtype classification. The aim of our study was to assess the potential role of distal compound muscle action potential (dCMAP) for early differentiation between acute inflammatory demyelinating polyneuropathy (AIDP) and axonal GBS.
We retrospectively reviewed the medical records of 24 subjects with AIDP and 18 subjects with axonal GBS. We built up receiver operating characteristic curves for total dCMAP duration and negative phase of dCMAP duration, in order to derive cut-off values able to differentiate between AIDP and axonal GBS.
The total duration of dCMAP was significantly prolonged in AIDP compared to axonal GBS. AUCs, odds ratio and positive predictive values were higher for total duration than for negative peak duration. Nerve conduction parameters in the lower limbs were more sensitive than those in the upper limbs in distinguishing AIDP from axonal GBS.
Total duration of dCMAP dispersion may capture an adjunctive component of distal demyelination, not measured by the more traditional parameters and may thus represent a useful tool for early differentiation between AIDP and axonal GBS.
电生理学在吉兰-巴雷综合征（GBS）的诊断和亚型分类中起着至关重要的作用。我们研究的目的是评估远端复合肌肉动作电位（dCMAP）在急性炎症性脱髓鞘性多发性神经病（AIDP）和轴索性GBS早期鉴别诊断中的潜在作用。
我们回顾性分析了24例AIDP患者和18例轴索性GBS患者的病历。我们绘制了dCMAP总时长和dCMAP时长负相的受试者工作特征曲线，以得出能够区分AIDP和轴索性GBS的临界值。
与轴索性GBS相比，AIDP患者的dCMAP总时长显著延长。dCMAP总时长的曲线下面积（AUC）、比值比和阳性预测值均高于负峰时长。在区分AIDP和轴索性GBS方面，下肢的神经传导参数比上肢更敏感。
dCMAP离散总时长可能反映了远端脱髓鞘的一个附加成分，这是传统参数未测量到的，因此可能是AIDP和轴索性GBS早期鉴别的有用工具。
