Electrodiagnostic methods to verify Guillain-Barré syndrome subtypes in Istanbul: A prospective multicenter study.
Guillain-Barré syndrome
anti-ganglioside antibodies
diagnostic criteria
electrodiagnosis
serial examinations
Journal
Journal of the peripheral nervous system : JPNS
ISSN: 1529-8027
Titre abrégé: J Peripher Nerv Syst
Pays: United States
ID NLM: 9704532
Informations de publication
Date de publication:
30 Jan 2024
30 Jan 2024
Historique:
revised:
07
01
2024
received:
16
07
2023
accepted:
09
01
2024
medline:
31
1
2024
pubmed:
31
1
2024
entrez:
31
1
2024
Statut:
aheadofprint
Résumé
This study aimed to identify the clinical characteristics and electrodiagnostic subtypes of Guillain-Barré syndrome (GBS) in Istanbul. Patients with GBS were prospectively recruited between April 2019 and March 2022 and two electrodiagnostic examinations were performed on each patient. The criteria of Ho et al., Hadden et al., Rajabally et al., and Uncini et al. were compared for the differentiation of demyelinating and axonal subtypes, and their relations with anti-ganglioside antibodies were analyzed. One hundred seventy-seven patients were included, 69 before the coronavirus disease 2019 pandemic (April 2019-February 2020) and 108 during the pandemic (March 2020-March 2022), without substantial changes in monthly frequencies. As compared with the criteria of Uncini et al., demyelinating GBS subtype diagnosis was more frequent according to the Ho et al. and Hadden et al. criteria (95/162, 58.6% vs. 110/174, 63.2% and 121/174, 69.5%, respectively), and less frequent according to Rajabally et al.'s criteria (76/174, 43.7%). Fourteen patients' diagnoses made using Rajabally et al.'s criteria were shifted to the other subtype with the second electrodiagnostic examination. Of the 106 analyzed patients, 22 had immunoglobulin G anti-ganglioside antibodies (14 with the axonal subtype). They had less frequent sensory symptoms (54.5% vs. 83.1%, p = 0.009), a more frequent history of previous gastroenteritis (54.5% vs. 22.9%, p = 0.007), and a more severe disease as compared with those without antibodies. Serial electrodiagnostic examinations are more helpful for accurate subtype diagnosis of GBS because of the dynamic pathophysiology of the disease. We observed no significant increase in GBS frequency during the pandemic in this metropolis.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
This study aimed to identify the clinical characteristics and electrodiagnostic subtypes of Guillain-Barré syndrome (GBS) in Istanbul.
METHODS
METHODS
Patients with GBS were prospectively recruited between April 2019 and March 2022 and two electrodiagnostic examinations were performed on each patient. The criteria of Ho et al., Hadden et al., Rajabally et al., and Uncini et al. were compared for the differentiation of demyelinating and axonal subtypes, and their relations with anti-ganglioside antibodies were analyzed.
RESULTS
RESULTS
One hundred seventy-seven patients were included, 69 before the coronavirus disease 2019 pandemic (April 2019-February 2020) and 108 during the pandemic (March 2020-March 2022), without substantial changes in monthly frequencies. As compared with the criteria of Uncini et al., demyelinating GBS subtype diagnosis was more frequent according to the Ho et al. and Hadden et al. criteria (95/162, 58.6% vs. 110/174, 63.2% and 121/174, 69.5%, respectively), and less frequent according to Rajabally et al.'s criteria (76/174, 43.7%). Fourteen patients' diagnoses made using Rajabally et al.'s criteria were shifted to the other subtype with the second electrodiagnostic examination. Of the 106 analyzed patients, 22 had immunoglobulin G anti-ganglioside antibodies (14 with the axonal subtype). They had less frequent sensory symptoms (54.5% vs. 83.1%, p = 0.009), a more frequent history of previous gastroenteritis (54.5% vs. 22.9%, p = 0.007), and a more severe disease as compared with those without antibodies.
INTERPRETATION
CONCLUSIONS
Serial electrodiagnostic examinations are more helpful for accurate subtype diagnosis of GBS because of the dynamic pathophysiology of the disease. We observed no significant increase in GBS frequency during the pandemic in this metropolis.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Scientific Research Projects Coordination Unit of Istanbul University
ID : TSA-2020-36889
Informations de copyright
© 2024 Peripheral Nerve Society.
Références
Doets AY, Verboon C, Van Den Berg B, et al. Regional variation of Guillain-Barré syndrome. Brain. 2018;141:2866-2877.
Shahrizaila N, Lehmann HC, Kuwabara S. Guillain-Barré syndrome. Lancet. 2021;397:1214-1228.
Hadden R, Cornblath D, Hughes R, et al. Electrophysiological classification of Guillain-Barré syndrome: clinical associations and outcome. Ann Neurol. 1998;44:780-788.
Ho T, Mishu B, Li C, et al. Guillain-Barre syndrome in northern China relationship to Campylobacter jejuni infection and anti-glycolipid antibodies. Brain. 1995;118:597-605.
Rajabally YA, Hiew FL, Winer JB. Influence of timing on electrodiagnosis of Guillain-Barre syndrome in the first six weeks: a retrospective study. J Neurol Sci. 2015;357:143-145.
Uncini A, Ippoliti L, Shahrizaila N, Sekiguchi Y, Kuwabara S. Optimizing the electrodiagnostic accuracy in Guillain-Barre syndrome subtypes: criteria sets and sparse linear discriminant analysis. Clin Neurophysiol. 2017;128:1176-1183.
Capasso M, Caporale C, Pomilio F, Gandolfi P, Lugaresi A, Uncini A. Acute motor conduction block neuropathy Another Guillain-Barré syndrome variant. Neurology. 2003;61:617-622.
Hiraga A, Kuwabara S, Ogawara K, et al. Patterns and serial changes in electrodiagnostic abnormalities of axonal Guillain-Barré syndrome. Neurology. 2005;64:856-860.
Kuwabara S, Ogawara K, Mizobuchi K, et al. Isolated absence of F waves and proximal axonal dysfunction in Guillain-Barre syndrome with antiganglioside antibodies. J Neurol Neurosurg Psychiatry. 2000;68:191-195.
Kuwabara S, Yuki N, Koga M, et al. IgG anti-GM1 antibody is associated with reversible conduction failure and axonal degeneration in Guillain-Barré syndrome. Ann Neurol. 1998;44:202-208.
Uncini A, Susuki K, Yuki N. Nodo-paranodopathy: beyond the demyelinating and axonal classification in anti-ganglioside antibody-mediated neuropathies. Clin Neurophysiol. 2013;124:1928-1934.
Shahrizaila N, Goh KJ, Abdullah S, Kuppusamy R, Yuki N. Two sets of nerve conduction studies may suffice in reaching a reliable electrodiagnosis in Guillain-Barre syndrome. Clin Neurophysiol. 2013;124:1456-1459.
Uncini A, Kuwabara S. Electrodiagnostic criteria for Guillain-Barre syndrome: a critical revision and the need for an update. Clin Neurophysiol. 2012;123:1487-1495.
Fokke C, van den Berg B, Drenthen J, Walgaard C, van Doorn PA, Jacobs BC. Diagnosis of Guillain-Barre syndrome and validation of Brighton criteria. Brain. 2014;137:33-43.
Islam Z, Jacobs B, van Belkum A, et al. Axonal variant of Guillain-Barre syndrome associated with Campylobacter infection in Bangladesh. Neurology. 2010;74:581-587.
Kushnir M, Klein C, Pollak L, Rabey J. Evolving pattern of Guillain-Barre syndrome in a community hospital in Israel. Acta Neurol Scand. 2008;117:347-350.
Sekiguchi Y, Uncini A, Yuki N, et al. Antiganglioside antibodies are associated with axonal Guillain-Barré syndrome: a Japanese-Italian collaborative study. J Neurol Neurosurg Psychiatry. 2012;83:23-28.
Van den Bergh PYK, Pieret F, Woodard JL, et al. Guillain-BarrE syndrome subtype diagnosis: A prospective multicentric European study. Muscle Nerve. 2018;58:23-28.
Sejvar JJ, Kohl KS, Gidudu J, et al. Guillain-Barre syndrome and Fisher syndrome: case definitions and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine. 2011;29:599-612.
Hughes R, Newsom-Davis J, Perkin G, Pierce J. Controlled trial of prednisolone in acute polyneuropathy. Lancet. 1978;312:750-753.
Kleyweg RP, Van Der Meché FG, Schmitz PI. Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain-Barré syndrome. Muscle Nerve. 1991;14:1103-1109.
van Koningsveld R, Steyerberg EW, Hughes RA, Swan AV, van Doorn PA, Jacobs BC. A clinical prognostic scoring system for Guillain-Barré syndrome. Lancet Neurol. 2007;6:589-594.
Albers JW, Kelly JJ Jr. Acquired inflammatory demyelinating polyneuropathies: clinical and electrodiagnostic features. Muscle Nerve. 1989;12:435-451.
Kuwabara S, Ogawara K, Misawa S, et al. Sensory nerve conduction in demyelinating and axonal Guillain-Barré syndromes. Eur Neurol. 2004;51:196-198.
Uncini A, Manzoli C, Notturno F, Capasso M. Pitfalls in electrodiagnosis of Guillain-Barré syndrome subtypes. J Neurol Neurosurg Psychiatry. 2010;81:1157-1163.
Uncini A, Kuwabara S. The electrodiagnosis of Guillain-Barré syndrome subtypes: where do we stand? Clin Neurophysiol. 2018;129:2586-2593.
Islam Z, Gilbert M, Mohammad QD, et al. Guillain-Barré syndrome-related Campylobacter jejuni in Bangladesh: ganglioside mimicry and cross-reactive antibodies. 2012.
Kim JK, Bae JS, Kim D-S, et al. Prevalence of anti-ganglioside antibodies and their clinical correlates with Guillain-Barré syndrome in Korea: a nationwide multicenter study. J Clin Neurol. 2014;10:94-100.
Ogawara K, Kuwabara S, Mori M, Hattori T, Koga M, Yuki N. Axonal Guillain-Barré syndrome: relation to anti-ganglioside antibodies and campylobacter jejuni infection in Japan. Ann Neurol. 2000;48:624-631.
Kokubun N, Shahrizaila N, Koga M, Hirata K, Yuki N. The demyelination neurophysiological criteria can be misleading in Campylobacter jejuni-related Guillain-Barré syndrome. Clin Neurophysiol. 2013;124:1671-1679.
Uncini A, Notturno F, Capasso M. Natura non facit saltus in anti-ganglioside antibody-mediated neuropathies. Muscle Nerve. 2013;48:484-487.
Rajabally YA, Durand M-C, Mitchell J, Orlikowski D, Nicolas G. Electrophysiological diagnosis of Guillain-Barré syndrome subtype: could a single study suffice? J Neurol Neurosurg Psychiatry. 2015;86:115-119.
Benedetti L, Briani C, Beronio A, et al. Increased incidence of axonal Guillain-Barré syndrome in La Spezia area of Italy: a 13-year follow-up study. J Peripher Nerv Syst. 2019;24:80-86.
Derksen A, Ritter C, Athar P, et al. Sural sparing pattern discriminates Guillain-Barré syndrome from its mimics. Muscle Nerve. 2014;50:780-784.
Umapathi T, Lim CSJ, Ng BCJ, Goh EJH, Ohnmar O. A simplified, graded, electrodiagnostic criterion for Guillain-Barré syndrome that incorporates sensory nerve conduction studies. Sci Rep. 2019;9:1-4.
Shahrizaila N, Kokubun N, Sawai S, et al. Antibodies to single glycolipids and glycolipid complexes in Guillain-Barré syndrome subtypes. Neurology. 2014;83:118-124.
Fan C, Jin H, Hao H, et al. Anti-ganglioside antibodies in Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy in Chinese patients. Muscle Nerve. 2017;55:470-475.
Mitsui Y, Kusunoki S, Arimura K, et al. A multicentre prospective study of Guillain-Barré syndrome in Japan: a focus on the incidence of subtypes. J Neurol Neurosurg Psychiatry. 2015;86:110-114.
Ho T, Willison H, Nachamkin I, et al. Anti-GD1a antibody is associated with axonal but not demyelinating forms of Guillain-Barré syndrome. Ann Neurol. 1999;45:168-173.
Yamagishi Y, Kuwahara M, Suzuki H, et al. Serum IgG anti-GD1a antibody and mEGOS predict outcome in Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry. 2020;91:1339-1342.
Abu-Rumeileh S, Abdelhak A, Foschi M, Tumani H, Otto M. Guillain-Barré syndrome spectrum associated with COVID-19: an up-to-date systematic review of 73 cases. J Neurol. 2021;268:1133-1170.
Filosto M, Cotti Piccinelli S, Gazzina S, et al. Guillain-Barré syndrome and COVID-19: a 1-year observational multicenter study. Eur J Neurol. 2022;29:3358-3367.
Filosto M, Piccinelli SC, Gazzina S, et al. Guillain-Barré syndrome and COVID-19: an observational multicentre study from two Italian hotspot regions. J Neurol Neurosurg Psychiatry. 2021;92:751-756.
Keddie S, Pakpoor J, Mousele C, et al. Epidemiological and cohort study finds no association between COVID-19 and Guillain-Barré syndrome. Brain. 2021;144:682-693.
Luijten LW, Leonhard SE, Van Der Eijk AA, et al. Guillain-Barré syndrome after SARS-CoV-2 infection in an international prospective cohort study. Brain. 2021;144:3392-3404.
Palaiodimou L, Stefanou MI, Katsanos AH, et al. Prevalence, clinical characteristics and outcomes of Guillain− Barré syndrome spectrum associated with COVID-19: a systematic review and meta-analysis. Eur J Neurol. 2021;28:3517-3529.
Uncini A, Foresti C, Frigeni B, et al. Electrophysiological features of acute inflammatory demyelinating polyneuropathy associated with SARS-CoV-2 infection. Neurophysiol Clin. 2021;51:183-191.
Uncini A, Vallat J-M, Jacobs BC. Guillain-Barré syndrome in SARS-CoV-2 infection: an instant systematic review of the first six months of pandemic. J Neurol Neurosurg Psychiatry. 2020;91:1105-1110.
Uncini A, Notturno F, Kuwabara S. Hyper-reflexia in Guillain-Barré syndrome: systematic review. J Neurol Neurosurg Psychiatry. 2020;91:278-284.
Hu M, Li X, Wong HY, Feng X-G, Wang Y-Z, Zhang G-R. Asymmetric limb weakness in Guillain-Barré syndrome: three case reports. World J Clin Cases. 2022;10:1896-1902.
Logullo F, Manicone M, Di Bella P, Provinciali L. Asymmetric Guillain-Barré syndrome. Neurol Sci. 2006;27:355-359.
Yosha-Orpaz N, Aharoni S, Rabie M, Nevo Y. Atypical clinical presentations of pediatric acute immune-mediated polyneuropathy. J Child Neurol. 2019;34:268-276.
Ropper AH. Further regional variants of acute immune polyneuropathy: bifacial weakness or sixth nerve paresis with paresthesias, lumbar polyradiculopathy, and ataxia with pharyngeal-cervical-brachial weakness. Arch Neurol. 1994;51:671-675.