Early electrodiagnostic features of upper extremity sensory nerves can differentiate axonal Guillain-Barré syndrome from acute inflammatory demyelinating polyneuropathy

Yong Seo Koo; Ha Young Shin; Jong Kuk Kim; Tai Seung Nam; Kyong Jin Shin; Jong Seok Bae; Bum Chun Suh; Jeeyoung Oh; Byeol A. Yoon; Byung Jo Kim

doi:10.3988/jcn.2016.12.4.495

Early electrodiagnostic features of upper extremity sensory nerves can differentiate axonal Guillain-Barré syndrome from acute inflammatory demyelinating polyneuropathy

Yong Seo Koo, Ha Young Shin, Jong Kuk Kim, Tai Seung Nam, Kyong Jin Shin, Jong Seok Bae, Bum Chun Suh, Jeeyoung Oh, Byeol A. Yoon, Byung Jo Kim

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Background and Purpose Serial nerve conduction studies (NCSs) are recommended for differentiating axonal and demyelinating Guillain-Barré syndrome (GBS), but this approach is not suitable for early diagnoses. This study was designed to identify possible NCS parameters for differentiating GBS subtypes. Methods We retrospectively reviewed the medical records of 70 patients with GBS who underwent NCS within 10 days of symptom onset. Patients with axonal GBS and acute inflammatory demyelinating polyneuropathy (AIDP) were selected based on clinical characteristics and serial NCSs. An antiganglioside antibody study was used to increase the diagnostic certainty. Results The amplitudes of median and ulnar nerve sensory nerve action potentials (SNAPs) were significantly smaller in the AIDP group than in the axonal-GBS group. Classification and regression-tree analysis revealed that the distal ulnar sensory nerve SNAP amplitude was the best predictor of axonal GBS. Conclusions Early upper extremity sensory NCS findings are helpful in differentiating axonal-GBS patients with antiganglioside antibodies from AIDP patients.

Original language	English
Pages (from-to)	495-501
Number of pages	7
Journal	Journal of Clinical Neurology (Korea)
Volume	12
Issue number	4
DOIs	https://doi.org/10.3988/jcn.2016.12.4.495
Publication status	Published - 2016 Oct
Externally published	Yes

Bibliographical note

Funding Information:
This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean Government (MSIP; no. NRF-2015R1 A5A7037674) and the Technology Innovation Program (or the Industrial Strategic Technology Development Program) (10049743, “Establishing a medical device development open platform, as a hub for accelerating close firm-hospital communication”) funded by the Ministry of Trade, Industry and Energy (MI, Korea).

Publisher Copyright:
© 2016 Korean Neurological Association.

Keywords

Acute inflammatory demyelinating polyneuropathy
Early diagnosis
Electrodiagnosis
Guillain-Barré syndrome
Neural conduction

ASJC Scopus subject areas

Neurology
Clinical Neurology

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10.3988/jcn.2016.12.4.495

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Koo, Y. S., Shin, H. Y., Kim, J. K., Nam, T. S., Shin, K. J., Bae, J. S., Suh, B. C., Oh, J., Yoon, B. A., & Kim, B. J. (2016). Early electrodiagnostic features of upper extremity sensory nerves can differentiate axonal Guillain-Barré syndrome from acute inflammatory demyelinating polyneuropathy. Journal of Clinical Neurology (Korea), 12(4), 495-501. https://doi.org/10.3988/jcn.2016.12.4.495

Early electrodiagnostic features of upper extremity sensory nerves can differentiate axonal Guillain-Barré syndrome from acute inflammatory demyelinating polyneuropathy. / Koo, Yong Seo; Shin, Ha Young; Kim, Jong Kuk et al.
In: Journal of Clinical Neurology (Korea), Vol. 12, No. 4, 10.2016, p. 495-501.

Research output: Contribution to journal › Article › peer-review

Koo, YS, Shin, HY, Kim, JK, Nam, TS, Shin, KJ, Bae, JS, Suh, BC, Oh, J, Yoon, BA & Kim, BJ 2016, 'Early electrodiagnostic features of upper extremity sensory nerves can differentiate axonal Guillain-Barré syndrome from acute inflammatory demyelinating polyneuropathy', Journal of Clinical Neurology (Korea), vol. 12, no. 4, pp. 495-501. https://doi.org/10.3988/jcn.2016.12.4.495

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title = "Early electrodiagnostic features of upper extremity sensory nerves can differentiate axonal Guillain-Barr{\'e} syndrome from acute inflammatory demyelinating polyneuropathy",

abstract = "Background and Purpose Serial nerve conduction studies (NCSs) are recommended for differentiating axonal and demyelinating Guillain-Barr{\'e} syndrome (GBS), but this approach is not suitable for early diagnoses. This study was designed to identify possible NCS parameters for differentiating GBS subtypes. Methods We retrospectively reviewed the medical records of 70 patients with GBS who underwent NCS within 10 days of symptom onset. Patients with axonal GBS and acute inflammatory demyelinating polyneuropathy (AIDP) were selected based on clinical characteristics and serial NCSs. An antiganglioside antibody study was used to increase the diagnostic certainty. Results The amplitudes of median and ulnar nerve sensory nerve action potentials (SNAPs) were significantly smaller in the AIDP group than in the axonal-GBS group. Classification and regression-tree analysis revealed that the distal ulnar sensory nerve SNAP amplitude was the best predictor of axonal GBS. Conclusions Early upper extremity sensory NCS findings are helpful in differentiating axonal-GBS patients with antiganglioside antibodies from AIDP patients.",

keywords = "Acute inflammatory demyelinating polyneuropathy, Early diagnosis, Electrodiagnosis, Guillain-Barr{\'e} syndrome, Neural conduction",

author = "Koo, {Yong Seo} and Shin, {Ha Young} and Kim, {Jong Kuk} and Nam, {Tai Seung} and Shin, {Kyong Jin} and Bae, {Jong Seok} and Suh, {Bum Chun} and Jeeyoung Oh and Yoon, {Byeol A.} and Kim, {Byung Jo}",

note = "Funding Information: This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean Government (MSIP; no. NRF-2015R1 A5A7037674) and the Technology Innovation Program (or the Industrial Strategic Technology Development Program) (10049743, “Establishing a medical device development open platform, as a hub for accelerating close firm-hospital communication”) funded by the Ministry of Trade, Industry and Energy (MI, Korea). Publisher Copyright: {\textcopyright} 2016 Korean Neurological Association.",

year = "2016",

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doi = "10.3988/jcn.2016.12.4.495",

language = "English",

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AU - Koo, Yong Seo

AU - Shin, Ha Young

AU - Kim, Jong Kuk

AU - Nam, Tai Seung

AU - Shin, Kyong Jin

AU - Bae, Jong Seok

AU - Suh, Bum Chun

AU - Oh, Jeeyoung

AU - Yoon, Byeol A.

AU - Kim, Byung Jo

N1 - Funding Information: This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean Government (MSIP; no. NRF-2015R1 A5A7037674) and the Technology Innovation Program (or the Industrial Strategic Technology Development Program) (10049743, “Establishing a medical device development open platform, as a hub for accelerating close firm-hospital communication”) funded by the Ministry of Trade, Industry and Energy (MI, Korea). Publisher Copyright: © 2016 Korean Neurological Association.

PY - 2016/10

Y1 - 2016/10

N2 - Background and Purpose Serial nerve conduction studies (NCSs) are recommended for differentiating axonal and demyelinating Guillain-Barré syndrome (GBS), but this approach is not suitable for early diagnoses. This study was designed to identify possible NCS parameters for differentiating GBS subtypes. Methods We retrospectively reviewed the medical records of 70 patients with GBS who underwent NCS within 10 days of symptom onset. Patients with axonal GBS and acute inflammatory demyelinating polyneuropathy (AIDP) were selected based on clinical characteristics and serial NCSs. An antiganglioside antibody study was used to increase the diagnostic certainty. Results The amplitudes of median and ulnar nerve sensory nerve action potentials (SNAPs) were significantly smaller in the AIDP group than in the axonal-GBS group. Classification and regression-tree analysis revealed that the distal ulnar sensory nerve SNAP amplitude was the best predictor of axonal GBS. Conclusions Early upper extremity sensory NCS findings are helpful in differentiating axonal-GBS patients with antiganglioside antibodies from AIDP patients.

AB - Background and Purpose Serial nerve conduction studies (NCSs) are recommended for differentiating axonal and demyelinating Guillain-Barré syndrome (GBS), but this approach is not suitable for early diagnoses. This study was designed to identify possible NCS parameters for differentiating GBS subtypes. Methods We retrospectively reviewed the medical records of 70 patients with GBS who underwent NCS within 10 days of symptom onset. Patients with axonal GBS and acute inflammatory demyelinating polyneuropathy (AIDP) were selected based on clinical characteristics and serial NCSs. An antiganglioside antibody study was used to increase the diagnostic certainty. Results The amplitudes of median and ulnar nerve sensory nerve action potentials (SNAPs) were significantly smaller in the AIDP group than in the axonal-GBS group. Classification and regression-tree analysis revealed that the distal ulnar sensory nerve SNAP amplitude was the best predictor of axonal GBS. Conclusions Early upper extremity sensory NCS findings are helpful in differentiating axonal-GBS patients with antiganglioside antibodies from AIDP patients.

KW - Acute inflammatory demyelinating polyneuropathy

KW - Early diagnosis

KW - Electrodiagnosis

KW - Guillain-Barré syndrome

KW - Neural conduction

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Early electrodiagnostic features of upper extremity sensory nerves can differentiate axonal Guillain-Barré syndrome from acute inflammatory demyelinating polyneuropathy

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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