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{{Guillain-Barré syndrome}}
{{Guillain-Barré syndrome}}


{{CMG}}; {{AE}} [[Priyamvada Singh|Priyamvada Singh, MBBS]] [mailto:psingh13579@gmail.com]
{{CMG}}; {{AE}} {{Fs}}


==Overview==
==Overview==
[[Nerve conduction study]] may show prolonged distal latencies, conduction slowing, conduction block, and temporal dispersion of compound action potential in demyelinating cases. Forced vital capacities also help in taking decisions regarding ventilators <ref name="pmid7867285">{{cite journal |author=Teitelbaum JS, Borel CO |title=Respiratory dysfunction in Guillain-Barré syndrome |journal=[[Clinics in Chest Medicine]] |volume=15 |issue=4 |pages=705–14 |year=1994 |month=December |pmid=7867285 |doi= |url= |accessdate=2012-02-24}}</ref>.
Nerve conduction studies and needle [[electromyography]] may be helpful in the diagnosis of Guillain Barre syndrome and differentiating various sub types. Findings diagnostic of [[demyelinating]] forms of Guillain Barre syndrome include: Reduced conduction velocity of [[motor nerves]], increased distal motor latency, increased latency of F wave, conduction block and Temporal scattering. Findings diagnostic of [[Axon|axonal]] forms of Guillain Barre syndrome include: Reduced amplitude of distal motor and/or sensory nerve impulses and conduction block of motor nerves.


==Other Diagnostic Studies==
==Other Diagnostic Studies==
===Electrodiagnostic tests===
* Nerve conduction studies and needle [[electromyography]] may be helpful in the diagnosis of Guillain Barre syndrome and differentiating various sub types.
ECD is used almost every time to verify symptoms, but because of the acute nature of the disease, they may not become abnormal until after the first week of onset of signs and symptoms.
 
The following tests may be ordered:
* Findings diagnostic of Guillain Barre syndrome include:<ref name="pmid9818934">{{cite journal |vauthors=Hadden RD, Cornblath DR, Hughes RA, Zielasek J, Hartung HP, Toyka KV, Swan AV |title=Electrophysiological classification of Guillain-Barré syndrome: clinical associations and outcome. Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group |journal=Ann. Neurol. |volume=44 |issue=5 |pages=780–8 |date=November 1998 |pmid=9818934 |doi=10.1002/ana.410440512 |url=}}</ref><ref name="pmid20855419">{{cite journal |vauthors=Kokubun N, Nishibayashi M, Uncini A, Odaka M, Hirata K, Yuki N |title=Conduction block in acute motor axonal neuropathy |journal=Brain |volume=133 |issue=10 |pages=2897–908 |date=October 2010 |pmid=20855419 |doi=10.1093/brain/awq260 |url=}}</ref><ref name="pmid26948435">{{cite journal |vauthors=Willison HJ, Jacobs BC, van Doorn PA |title=Guillain-Barré syndrome |journal=Lancet |volume=388 |issue=10045 |pages=717–27 |date=August 2016 |pmid=26948435 |doi=10.1016/S0140-6736(16)00339-1 |url=}}</ref>
* '''Electrodiagnostics''' -
** In [[demyelinating]] forms:
** [[Electromyography]] (EMG)-[[EMG]] tests the electrical activity in [[muscles]]. It may show that [[nerves]] do not react properly to stimulation.
*** Reduced conduction velocity of [[motor nerves]].
** [[Nerve conduction study]]
*** Increased distal motor latency.
*** (NCS) may show prolonged distal latencies, conduction slowing, conduction block, and temporal dispersion of compound action potential in demyelinating cases.
*** Increased latency of F wave.
*** In primary axonal damage, the findings include reduced amplitude of the action potentials without conduction slowing.
*** conduction block
*** Nerve motor action potentials may be decreased. Compound muscle action potential (CMAP) amplitude may be decreased.
*** Temporal scattering
*** The extent of decreased action potentials correlates with prognosis. Prolonged distal latencies may be present. Abnormal H-reflex may be noted.
** In [[Axon|axonal]] forms:
*** Needle examination shows profuse and early denervation potentials also support the conclusion that there has been axonal injury
*** Reduced amplitude of distal motor and/or sensory nerve impulses.
===Pulmonary Function Test===
*** Conduction block of motor nerves.
* Pulmonary function test (Maximal inspiratory pressures, maximal expiratory pressures and forced vital capacities) should be done regularly to monitor patients' respiratory performances and any need for ventilator.
* Forced vital capacities also help in taking decisions regarding ventilators <ref name="pmid7867285">{{cite journal |author=Teitelbaum JS, Borel CO |title=Respiratory dysfunction in Guillain-Barré syndrome |journal=[[Clinics in Chest Medicine]] |volume=15 |issue=4 |pages=705–14 |year=1994 |month=December |pmid=7867285 |doi= |url= |accessdate=2012-02-24}}</ref>.
===Muscle Biopsy===
* It is not commonly done but may be used as an adjunct to rule out myopathies (in cases of diagnostic dilemmas)


==References==
==References==

Latest revision as of 17:16, 27 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Nerve conduction studies and needle electromyography may be helpful in the diagnosis of Guillain Barre syndrome and differentiating various sub types. Findings diagnostic of demyelinating forms of Guillain Barre syndrome include: Reduced conduction velocity of motor nerves, increased distal motor latency, increased latency of F wave, conduction block and Temporal scattering. Findings diagnostic of axonal forms of Guillain Barre syndrome include: Reduced amplitude of distal motor and/or sensory nerve impulses and conduction block of motor nerves.

Other Diagnostic Studies

  • Nerve conduction studies and needle electromyography may be helpful in the diagnosis of Guillain Barre syndrome and differentiating various sub types.
  • Findings diagnostic of Guillain Barre syndrome include:[1][2][3]
    • In demyelinating forms:
      • Reduced conduction velocity of motor nerves.
      • Increased distal motor latency.
      • Increased latency of F wave.
      • conduction block
      • Temporal scattering
    • In axonal forms:
      • Reduced amplitude of distal motor and/or sensory nerve impulses.
      • Conduction block of motor nerves.

References

  1. Hadden RD, Cornblath DR, Hughes RA, Zielasek J, Hartung HP, Toyka KV, Swan AV (November 1998). "Electrophysiological classification of Guillain-Barré syndrome: clinical associations and outcome. Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group". Ann. Neurol. 44 (5): 780–8. doi:10.1002/ana.410440512. PMID 9818934.
  2. Kokubun N, Nishibayashi M, Uncini A, Odaka M, Hirata K, Yuki N (October 2010). "Conduction block in acute motor axonal neuropathy". Brain. 133 (10): 2897–908. doi:10.1093/brain/awq260. PMID 20855419.
  3. Willison HJ, Jacobs BC, van Doorn PA (August 2016). "Guillain-Barré syndrome". Lancet. 388 (10045): 717–27. doi:10.1016/S0140-6736(16)00339-1. PMID 26948435.

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