Ultrasound and electrophysiologic findings in patients with Guillain-Barré syndrome at disease onset and over a period of six months
Grimm A, Decard BF, Schramm A, Proebstel AK, Rasenack M, Axer H, Fuhr P (2016)
Publication Type: Journal article
Publication year: 2016
Journal
Book Volume: 127
Pages Range: 1657-63
Journal Issue: 2
DOI: 10.1016/j.clinph.2015.06.032
Abstract
To investigate cross-sectional areas (CSAs) of several peripheral nerves including the vagus nerve and the diameter of spinal nerves as measured by nerve ultrasound (NUS) and nerve conduction studies (NCS) in Guillain-Barré syndrome (GBS) patients over at least six months compared to healthy controls.NUS and/or NCS of several nerves, the vagus nerve, and the 5th/6th cervical spinal nerves were performed in patients with GBS at days 2-3 after symptom onset, at days 10-14 after immunoglobulin therapy and after six months compared to healthy controls.27 GBS-patients and 31 controls were included. Using NUS significant enlargement was found in all measured nerves (P<0.001), except the sural nerve (P=0.086) compared to the controls at onset. The vagus (median 3.0mm(2) vs. 2.0mm(2), P<0.0001) and the cervical spinal nerves were significantly enlarged (median 3.5/4.0mm vs. 2.6/3.2mm, p<0.0001), the vagus most obviously in patients with autonomic dysregulation (AD, 4.0mm(2)). Six months later, NCS showed persisting pathology in CMAP-amplitudes with amelioration of F-wave pathology. NUS showed restitution in the spinal nerves (median 2.6/3.2mm) and the vagus (median 2.0mm(2)) in all patients excluding the vagus in those with persistent AD (median 4.0mm(2)). The peripheral nerves did not change significantly (P>0.05).Ultrasonographic detection of cervical spinal nerve enlargement supports the diagnosis of GBS in the early phase. Its regression may be a good parameter for the clinical restitution over time. Vagus enlargement may be a risk marker for development of AD.Ultrasound is a reliable diagnostic follow-up tool in early GBS.
Involved external institutions
Switzerland (CH)
Germany (DE)How to cite
APA:
Grimm, A., Decard, B.F., Schramm, A., Proebstel, A.-K., Rasenack, M., Axer, H., & Fuhr, P. (2016). Ultrasound and electrophysiologic findings in patients with Guillain-Barré syndrome at disease onset and over a period of six months. Clinical Neurophysiology, 127(2), 1657-63. https://dx.doi.org/10.1016/j.clinph.2015.06.032
MLA:
Grimm, Alexander, et al. "Ultrasound and electrophysiologic findings in patients with Guillain-Barré syndrome at disease onset and over a period of six months." Clinical Neurophysiology 127.2 (2016): 1657-63.
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