Electrodiagnostic subtyping in Guillain-Barré syndrome patients in the International Guillain-Barré Outcome Study.
Guillain–Barré syndrome
amyotrophic lateral sclerosis
electrodiagnosis
nerve conduction studies
polyneuropathy
Journal
European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311
Informations de publication
Date de publication:
04 Jul 2024
04 Jul 2024
Historique:
revised:
23
04
2024
received:
09
02
2024
accepted:
29
04
2024
medline:
5
7
2024
pubmed:
5
7
2024
entrez:
5
7
2024
Statut:
aheadofprint
Résumé
Various electrodiagnostic criteria have been developed in Guillain-Barré syndrome (GBS). Their performance in a broad representation of GBS patients has not been evaluated. Motor conduction data from the International GBS Outcome Study (IGOS) cohort were used to compare two widely used criterion sets and relate these to diagnostic amyotrophic lateral sclerosis criteria. From the first 1500 patients in IGOS, nerve conduction studies from 1137 (75.8%) were available for the current study. These patients were classified according to nerve conduction studies criteria proposed by Hadden and Rajabally. Of the 1137 studies, 68.3% (N = 777) were classified identically according to criteria by Hadden and Rajabally: 111 (9.8%) axonal, 366 (32.2%) demyelinating, 195 (17.2%) equivocal, 35 (3.1%) inexcitable and 70 (6.2%) normal. Thus, 360 studies (31.7%) were classified differently. The areas of differences were as follows: 155 studies (13.6%) classified as demyelinating by Hadden and axonal by Rajabally; 122 studies (10.7%) classified as demyelinating by Hadden and equivocal by Rajabally; and 75 studies (6.6%) classified as equivocal by Hadden and axonal by Rajabally. Due to more strictly defined cutoffs fewer patients fulfilled demyelinating criteria by Rajabally than by Hadden, making more patients eligible for axonal or equivocal classification by Rajabally. In 234 (68.6%) axonal studies by Rajabally the revised El Escorial (amyotrophic lateral sclerosis) criteria were fulfilled; in axonal cases by Hadden this was 1.8%. This study shows that electrodiagnosis in GBS is dependent on the criterion set utilized, both of which are based on expert opinion. Reappraisal of electrodiagnostic subtyping in GBS is warranted.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Various electrodiagnostic criteria have been developed in Guillain-Barré syndrome (GBS). Their performance in a broad representation of GBS patients has not been evaluated. Motor conduction data from the International GBS Outcome Study (IGOS) cohort were used to compare two widely used criterion sets and relate these to diagnostic amyotrophic lateral sclerosis criteria.
METHODS
METHODS
From the first 1500 patients in IGOS, nerve conduction studies from 1137 (75.8%) were available for the current study. These patients were classified according to nerve conduction studies criteria proposed by Hadden and Rajabally.
RESULTS
RESULTS
Of the 1137 studies, 68.3% (N = 777) were classified identically according to criteria by Hadden and Rajabally: 111 (9.8%) axonal, 366 (32.2%) demyelinating, 195 (17.2%) equivocal, 35 (3.1%) inexcitable and 70 (6.2%) normal. Thus, 360 studies (31.7%) were classified differently. The areas of differences were as follows: 155 studies (13.6%) classified as demyelinating by Hadden and axonal by Rajabally; 122 studies (10.7%) classified as demyelinating by Hadden and equivocal by Rajabally; and 75 studies (6.6%) classified as equivocal by Hadden and axonal by Rajabally. Due to more strictly defined cutoffs fewer patients fulfilled demyelinating criteria by Rajabally than by Hadden, making more patients eligible for axonal or equivocal classification by Rajabally. In 234 (68.6%) axonal studies by Rajabally the revised El Escorial (amyotrophic lateral sclerosis) criteria were fulfilled; in axonal cases by Hadden this was 1.8%.
CONCLUSIONS AND DISCUSSION
CONCLUSIONS
This study shows that electrodiagnosis in GBS is dependent on the criterion set utilized, both of which are based on expert opinion. Reappraisal of electrodiagnostic subtyping in GBS is warranted.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e16335Investigateurs
James M Addington
(JM)
Umesh A Badrising
(UA)
Fabio A Barroso
(FA)
Kathleen Bateman
(K)
Isabelita Bella
(I)
Luana Benedetti
(L)
Bianca van den Berg
(B)
Ratna Bhavaraju-Sanka
(R)
Chiara Briani
(C)
Jan Buermann
(J)
Mark Busby
(M)
Steven Butterworth
(S)
Carlos Casasnovas
(C)
Shan Chen
(S)
Kristl Claeys
(K)
Eugenia Conti
(E)
Jeremy S Cosgrove
(JS)
Marinos Dalakas
(M)
Philip van Damme
(P)
Efthimios Dardiotis
(E)
Amy Davidson
(A)
Alex Doets
(A)
Pieter van Doorn
(P)
Andoni Echaniz-Laguna
(A)
Filip Eftimov
(F)
Karin G Faber
(KG)
Raffaella Fazio
(R)
Thomas E Feasby
(TE)
Janev Fehmi
(J)
Chris Fokke
(C)
Toshiki Fujioka
(T)
Ernesto Fulgenzi
(E)
Marcel P J Garssen
(MPJ)
Cees J Gijsbers
(CJ)
James M Gilchrist
(JM)
Job Gilhuis
(J)
Jonathan M Goldstein
(JM)
Kenneth C Gorson
(KC)
Namita Goyal
(N)
Volkan Granit
(V)
Ludwig Gutmann
(L)
Hans-Peter Hartung
(HP)
James K L Holt
(JKL)
Sung-Tsang Hsieh
(ST)
Min Htut
(M)
Richard A C Hughes
(RAC)
Ivonne Jericó-Pascual
(I)
Kenichi Kaida
(K)
Summer Karafiath
(S)
Mohammad Ali Khoshnoodi
(MA)
Lynette Kiers
(L)
Ruud P Kleiweg
(RP)
Norito Kokubun
(N)
Noah A Kolb
(NA)
Rinske van Koningsveld
(R)
Anneke J van der Kooi
(AJ)
Hans Kramers
(H)
Krista Kuitwaard
(K)
Justin Y Kwan
(JY)
Shafeeq S Ladha
(SS)
Lisbeth Landschoff Lassen
(LL)
Victoria H Lawson
(VH)
Helmar Lehmann
(H)
Luciana Leon Cejas
(LL)
Sonja E Leonhard
(SE)
Linda Luijten
(L)
Michael P T Lunn
(MPT)
Hadi Manji
(H)
Girolama A Marfia
(GA)
Celedonio Márquez Infante
(CM)
Lorena Martín-Aguilar
(L)
Eugenia Martinez-Hernandez
(E)
Giorgia Mataluni
(G)
Marcelo Mattiazzi
(M)
Christopher McDermott
(C)
Gregg Meekins
(G)
Quazi Deen Mohammad
(QD)
Soledad Monges
(S)
Germán Moris de la Tassa
(GM)
Caterina Nascimbene
(C)
Eduardo Nobile-Orazio
(E)
Richard J Nowak
(RJ)
Michael Osei-Bonsu
(M)
Farah Pelouto
(F)
Michael T Pulley
(MT)
Luis Querol Gutiérrez
(LQ)
Stephen W Reddel
(SW)
Taco van der Ree
(T)
Simon Rinaldi
(S)
Paolo Ripellino
(P)
Rhys C Roberts
(RC)
Iñigo Rojas-Marcos
(I)
Joyce Roodbol
(J)
Stacy A Rudnicki
(SA)
George M Sachs
(GM)
Johnny P A Samijn
(JPA)
Lucio Santoro
(L)
Angelo Schenone
(A)
Maria José Sedano Tous
(MJS)
Kazim A Sheikh
(KA)
Nicholas Joseph Silvestri
(NJ)
Soeren H Sundrup
(SH)
Claudia Sommer
(C)
Beth Stein
(B)
Amro Maher Stino
(AM)
Robin C M Thomma
(RCM)
Paul Twydell
(P)
Jay D Varrato
(JD)
Frederique H Vermeij
(FH)
Jan Verschuuren
(J)
Leo H Visser
(LH)
Christa Walgaard
(C)
Yuzhong Wang
(Y)
Hugh J Willison
(HJ)
Paul W Wirtz
(PW)
Marieke van Woerkom
(M)
Sascha A Zivkovic
(SA)
Informations de copyright
© 2024 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
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