Guillain-Barré syndrome other diagnostic studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [2]
Overview
Guillain-Barré syndrome (GBS) is an acute, autoimmune, polyradiculoneuropathy affecting the peripheral nervous system, usually triggered by an acute infectious process. It is included in the wider group of peripheral neuropathies. There are several types of GBS, but unless otherwise stated, GBS refers to the most common form, acute inflammatory demyelinating polyneuropathy (AIDP). It is frequently severe and usually exhibits as an ascending paralysis noted by weakness in the legs that spreads to the upper limbs and the face along with complete loss of deep tendon reflexes. With prompt treatment of plasmapheresis followed by immunoglobulins and supportive care, the majority of patients will regain full functional capacity. However, death may occur if severe pulmonary complications and dysautonomia are present.
Other diagnostic studies
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:
- Electrodiagnostics -
- Electromyography (EMG)-EMG tests the electrical activity in muscles. It may show that nerves do not react properly to stimulation.
- Nerve conduction study
- (NCS) may show prolonged distal latencies, conduction slowing, conduction block, and temporal dispersion of compound action potential in demyelinating cases.
- In primary axonal damage, the findings include reduced amplitude of the action potentials without conduction slowing.
Nerve motor action potentials may be decreased. Compound muscle action potential (CMAP) amplitude may be decreased.
- The extent of decreased action potentials correlates with prognosis. Prolonged distal latencies may be present. Abnormal H-reflex may be noted.
- Needle examination shows profuse and early denervation potentials also support the conclusion that there has been axonal injury