Electrodiagnostic methods to verify Guillain-Barré syndrome subtypes in Istanbul: A prospective multicenter study.
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Tasdemir Volkan, Sirin Nermin Gorkem, Cakar Arman, Culha Ayla, Soysal Aysun, Elmali Ayse Deniz, Gunduz Aysegul, Arslan Beyza, Yalcin Destina, Atakli Dilek, Orhan Elif Kocasoy, Sanli Elif, Tuzun Erdem, Gozke Eren, Gursoy Esra, Savrun Feray Karaali, Uslu Ferda Ilgen, Aysal Fikret, Durmus Hacer, Bulbul Hafsa, Ertas F Inci, Uluc Kayihan, Tutkavul Kemal, Baysal Leyla, Baslo Mehmet Baris, Kiziltan Meral, Mercan Metin, Pazarci Nevin, Uzun Nurten, Akan Onur, Cokar Ozlem, Koytak Pinar Kahraman, Sürmeli Reyhan, Gunaydin Sefer, Ayas Selahattin, Baslo Sezin Alpaydin, Yayla Vildan, Yilmaz Vuslat, Parman Yesim, Matur Zeliha, Acar Zeynep Unlusoy, Oge Ali Emre
Аннотация
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: 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: 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.