Electrodiagnostic subtyping in Guillain-Barré syndrome patients in the International Guillain-Barré Outcome Study

Arends S 1 , Drenthen J 1 , de Koning L 1 , van den Bergh P 2 , Hadden RDM 3 , Kuwabara S 4 Show all authors , Reisin RC 5 , Shahrizaila N 6 , Ajroud-Driss S 7 , Antonini G 8 , Attarian S 9 , Balducci C 10 , Bertorini T 11 , Brannagan TH 12 , Cavaletti G 10 , Chao CC 13 , Chavada G 14 , Dillmann KU 15 , Dimachkie MM 16 , Galassi G 17 , Gutiérrez-Gutiérrez G 18 , Harbo T 19 , Islam B 20 , Islam Z 21 , Katzberg H 22 , Kusunoki S 23 , Manganelli F 24 , Miller JAL 25 , Pardo J 26 , Pereon Y 27 , Rajabally YA 28 , Sindrup S 29 , Stettner M 30 , Uncini A 31 , Verhamme C 32 , Vytopil M 33 , Waheed W 34 , Jacobs BC 1 , Cornblath DR 35 , IGOS Consortium

Affiliations 

  • 1 Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
  • 2 Department of Neurology, University Hospital St-Luc, Brussels, Belgium
  • 3 Department of Neurology, King's College Hospital, London, UK
  • 4 Department of Neurology, Chiba University Hospital, Chiba, Japan
  • 5 Department of Neurology, Hospital Británico, Buenos Aires, Argentina
  • 6 Department of Neurology, University of Malaya, Kuala Lumpur, Malaysia
  • 7 Department of Neurology, Northwestern University Feinberg, Chicago, Illinois, USA
  • 8 Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University, Rome, Italy
  • 9 Department Neuromuscular disorders, Hôpital de la Timone, Marseille, France
  • 10 Department of Neurology, San Gerardo Hospital, Monza, Italy
  • 11 University of Tennessee Health Science Center, Department of Neurology, Memphis, Tennessee, USA
  • 12 Department of Neurology, Colombia University, New York, New York, USA
  • 13 Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
  • 14 Department of Neurology, Southern General Hospital, University of Glasgow, Glasgow, UK
  • 15 Department of Neurology, Universitätsklinikum des Saarlandes, Homburg, Germany
  • 16 Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
  • 17 Department of Neurology, University Hospital of Modena, Modena, Italy
  • 18 Department of Neurology, Hospital Universitario Infanta Sofia, Universidad Europea de Madrid, San Sebastian de los Reyes, Spain
  • 19 Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
  • 20 Department of Neurology and Neurophysiology, BRB Hospital, Dhaka, Bangladesh
  • 21 International Centre for Diarrhoeal Disease Research (icddr;b), Laboratory of Gut-Brain Axis, Dhaka, Bangladesh
  • 22 University of Toronto, Department of Neurology, Toronto, Canada
  • 23 Department of Neurology, Kindai University, Osaka, Japan
  • 24 Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
  • 25 Department of Neurology, Royal Victoria Infirmary, Newcastle, UK
  • 26 Department of Neurology, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
  • 27 Department of Clinical Neurophysiology, Nantes University Hospital, Nantes, France
  • 28 Aston Medical School, Aston University, Birmingham, UK
  • 29 Odense University Hospital, Department of Neurology, Odense, Denmark
  • 30 Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, Essen, Germany
  • 31 Department of Neuroscience, Imaging and Clinical Sciences, University 'G. D'Annunzio', Chieti, Italy
  • 32 Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
  • 33 Department of Neurology, Lahey Hospital and Medical Center, Burlington, Vermont, USA
  • 34 Department of Neurology, University of Vermont Medical Centre, Burlington, Vermont, USA
  • 35 Department of Neurology, Johns Hopkins University, Baltimore, Vermont, USA
Eur J Neurol, 2024 Jul 04.
PMID: 38965709 DOI: 10.1111/ene.16335

Abstract

BACKGROUND AND PURPOSE: 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: 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: 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: 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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