Article, 2024

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

European Journal of Neurology, ISSN 1468-1331, 1351-5101, Page e16335, 10.1111/ene.16335

Contributors

Arends, Samuel 0000-0003-4279-4657 (Corresponding author) [1] [2] Drenthen, Judith [2] de Koning, Laura [2] Van Den Bergh, Peter Y K 0000-0003-1954-4617 [3] Hadden, Robert D M 0000-0002-9702-0256 [4] Kuwabara, Satoshi [5] Reisin, Ricardo Claudio 0000-0002-7278-4639 [6] Shahrizaila, Nortina Bt 0000-0003-0031-7692 [7] Ajroud-Driss, Senda [8] Antonini, Giovanni [9] Attarian, Shahram 0000-0002-7211-4694 [10] Balducci, Claudia [11] Bertorini, Tulio E [12] Brannagan, Thomas H. [13] Cavaletti, Guido Angelo 0000-0003-4128-2406 [11] Chao, Chi‐Chao [14] Chavada, Govind [15] [16] Dillmann, Klaus-Ulrich [17] Dimachkie, Mazen M. [18] Galassi, Giuliana [19] Gutiérrez-Gutiérrez, Gerardo 0000-0003-1391-754X [20] Harbo, Thomas 0000-0003-2178-6076 [21] Islam, Badrul M 0000-0003-0829-2522 [22] Islam, Zhahirul [23] Katzberg, Hans [24] Kusunoki, Susumu [25] Manganelli, Fiore 0000-0002-1442-9604 [26] Miller, James A. L. [27] Pardo, Julio [28] Péréon, Yann 0000-0002-0090-3571 [29] Rajabally, Yusuf Ali [30] Sindrup, Søren Hein 0000-0003-0357-8628 [31] Stettner, Mark [32] Uncini, Antonino [33] Verhamme, Camiel 0000-0002-0444-574X [34] Vytopil, Michal [35] Waheed, Waqar 0000-0001-7810-000X [36] Jacobs, Bart C. [2] Cornblath, David R. [37] Consortium, The IGOS

Affiliations

  1. [1] Haga Hospital
    2. [NORA names: Netherlands; Europe, EU; OECD];
  2. [2] Erasmus MC
    3. [NORA names: Netherlands; Europe, EU; OECD];
  3. [3] Cliniques Universitaires Saint-Luc
    4. [NORA names: Belgium; Europe, EU; OECD];
  4. [4] King's College Hospital
    5. [NORA names: United Kingdom; Europe, Non-EU; OECD];
  5. [5] Chiba University Hospital
    6. [NORA names: Japan; Asia, East; OECD];

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.

Keywords

El Escorial, Escorial, GBS patients, Hadden, International, International GBS Outcome Study, Rajab, area, areas of difference, axon studies, axonal cases, cases, classification, cohort, conduction studies, conductivity data, criteria, criteria sets, cutoff, data, demyelination, differences, electrodiagnosis, electrodiagnostic criteria, expert opinion, fewer patients, motor, motor conduction data, nerve, nerve conduction studies, nerve conduction studies criteria, opinion, outcome studies, patients, performance, representation, revised El Escorial, sets, study, study criteria, subtypes, syndrome, syndrome patients

Funders

  • National Institutes of Health
  • Prinses Beatrix Spierfonds
  • United States Food and Drug Administration

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