Guillain–Barré syndrome subtypes: A clinical electrophysiological study of 100 patients - 14/11/18

Doi : 10.1016/j.neurol.2018.01.379

A.-M. Grapperon ^a,^⁎ , M. Berro ^a, E. Salort-Campana ^a, A. Verschueren ^a, E. Delmont ^a,^b, S. Attarian ^a,^c
^a Referral Center for Neuromuscular Diseases and ALS, AP–HM, Timone University Hospital, 13385 Marseille, France
^b CNR2M, CNRS UMR 7286, Aix-Marseille University, 13005 Marseille, France
^c INSERM UMR S 910, Aix-Marseille University, 13005 Marseille, France

^⁎Corresponding author. Centre de référence des maladie neuromusculaires et de la SLA, pôle de neurosciences, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.Centre de référence des maladie neuromusculaires et de la SLA, pôle de neurosciences, CHU Timone264, rue Saint-PierreMarseille cedex 0513385France

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Abstract

Introduction

A retrospective analysis was performed to document the clinical and electrophysiological features of Guillain-Barré syndrome (GBS) subtypes using different diagnostic criteria.

Methods

One hundred GBS patients were included. Clinical and laboratory features were analyzed, and patients were classified according to four sets of diagnostic criteria. Electrodiagnostic criteria were also analyzed.

Results

A total of 69 patients met Asbury and Cornblath's criteria, 96 met Van der Meché’s criteria, 99 met Wakerley's diagnostic classification and 86 met level 1 or 2 of the Brighton criteria. Rates of GBS subtypes were: 69% classic GBS; 8% Miller–Fisher syndrome; 12% paraparetic GBS; 2% pharyngeal–cervical–brachial GBS; and 9% unclassified. Those for electrodiagnostic subtypes were 52% demyelinating and 9% axonal according to Hadden's criteria vs 41% demyelinating and 41% axonal as per Rajabally's criteria.

Conclusion

In this study of case distribution within the GBS spectrum of a retrospective cohort of French patients, the application of new diagnostic criteria enabled accurate diagnoses and classifications of the different subtypes, and also increased the recognition of axonal GBS.

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Keywords : Guillain-Barré syndrome, Diagnostic criteria, Electrodiagnostic criteria, GBS subtypes, Miller-Fisher syndrome, Paraparetic GBS

Abbreviations : AMAN, BBE, CSF, GBS, MFS, NCS, PCB, P-GBS