@article{10902/18950,
year = {2019},
url = {http://hdl.handle.net/10902/18950},
abstract = {Objectives: Using recent optimized electrodiagnostic criteria sets, we primarily aimed at verifying the accuracy of the initial electrophysiological test in very early Guillain-Barré syndrome (VEGBS), ?4 days of onset, compared with the results of serial electrophysiology. Our secondary objective was to correlate early electrophysiological results with sonographic nerve changes.

Methods: This is a retrospective study based on consecutive VEGBS patients admitted to the hospital. Each patient had serial nerve conduction studies (NCS) in at least 4 nerves. Initial NCS were done within 4 days after onset, and serial ones from the second week onwards. Electrophysiological recordings of each case were re-evaluated, GBS subtype being established accordingly. Nerve ultrasonography was almost always performed within 2 weeks after onset.

Results: Fifteen adult VEGBS patients were identified with a mean age of 57.8 years. At first NCS, VEGBS sub-typing was only possible in 3 (20%) cases that showed an axonal pattern, the remaining patterns being mixed (combining axonal and demyelinating features) in 6 (40%), equivocal in 5 (33.3%), and normal in 1 (6.7%). Upon serial NCS, 7 (46.7%) cases were categorized as acute demyelinating polyneuropathy, 7 (46.7%) as axonal GBS, and 1 (6.6%) as unclassified syndrome. Antiganglioside reactivity was detected in 5 out of the 7 axonal cases. Nerve US showed that lesions mainly involved the ventral rami of scanned cervical nerves.

Conclusions: Serial electrophysiological evaluation is necessary for accurate VEGBS subtype classification. Ultrasonography helps delineate the topography of nerve changes.

Significance: We provide new VEGBS pathophysiological insights into nerve conduction alterations within the first 4 days of the clinical course.},
organization = {Acknowledgement: This paper was supported by IDIVAL (ID APG/11) and CIBERNED. The authors are most grateful to Mrs Marta de la Fuente for secretarial assistance.},
publisher = {Elsevier},
publisher = {Clin Neurophysiol Pract
. 2019 Nov 30;5:1-9},
title = {Very early Guillain-Barré syndrome: A clinical-electrophysiological and ultrasonographic study},
author = {Berciano, José Ángel and Orizaola, Pedro and Gallardo Agromayor, Elena Carmen and Pelayo-Negro, Ana L. and Sánchez-Juan, Pascual and Infante Ceberio, Jon and Sedano Tous, María José},
}