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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1995 Nov;59(5):482–486. doi: 10.1136/jnnp.59.5.482

Electrodiagnostic criteria for polyneuropathy and demyelination: application in 135 patients with Guillain-Barré syndrome. Dutch Guillain-Barré Study Group.

J Meulstee 1, F G van der Meché 1
PMCID: PMC1073708  PMID: 8530930

Abstract

Since the development of effective but expensive therapeutic strategies for the treatment of Guillain-Barré syndrome, early confirmation of the diagnosis has become very important. Electrodiagnostic criteria were developed for the discrimination of polyneuropathy and in particular for demyelination. The sensitivity and specificity of these criteria were determined in 135 patients with Guillain-Barré syndrome in an early stage of the disease, along with 45 healthy volunteers. The algorithms used to develop our criteria consisted of sets of selected electrodiagnostic variables, each of them relevant to the detection of polyneuropathy. Each set was applied on all of three consecutive electrodiagnostic examinations within one month of disease onset. Application of the best set resulted in 85% of patients with Guillain-Barré syndrome fulfilling the criteria for polyneuropathy at the first examination (mean time interval six days of disease onset), whereas none of the healthy volunteers fulfilled the criteria (sensitivity 85%, specificity 100%). The set of criteria for the detection of demyelination was fulfilled by 60% during the first examination (by 66% and 72% during the second and third examination). Application of criteria for demyelinating polyneuropathy as defined by others resulted in substantially lowered incidence (3%-46%). It is concluded that these criteria for the electrodiagnostic delineation of polyneuropathy are the most sensitive to date, with respect to the early confirmation of the diagnosis of Guillain-Barré syndrome.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albers J. W., Donofrio P. D., McGonagle T. K. Sequential electrodiagnostic abnormalities in acute inflammatory demyelinating polyradiculoneuropathy. Muscle Nerve. 1985 Jul-Aug;8(6):528–539. doi: 10.1002/mus.880080609. [DOI] [PubMed] [Google Scholar]
  2. Albers J. W., Kelly J. J., Jr Acquired inflammatory demyelinating polyneuropathies: clinical and electrodiagnostic features. Muscle Nerve. 1989 Jun;12(6):435–451. doi: 10.1002/mus.880120602. [DOI] [PubMed] [Google Scholar]
  3. Asbury A. K., Arnason B. G., Adams R. D. The inflammatory lesion in idiopathic polyneuritis. Its role in pathogenesis. Medicine (Baltimore) 1969 May;48(3):173–215. doi: 10.1097/00005792-196905000-00001. [DOI] [PubMed] [Google Scholar]
  4. Asbury A. K., Cornblath D. R. Assessment of current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol. 1990;27 (Suppl):S21–S24. doi: 10.1002/ana.410270707. [DOI] [PubMed] [Google Scholar]
  5. Barohn R. J., Kissel J. T., Warmolts J. R., Mendell J. R. Chronic inflammatory demyelinating polyradiculoneuropathy. Clinical characteristics, course, and recommendations for diagnostic criteria. Arch Neurol. 1989 Aug;46(8):878–884. doi: 10.1001/archneur.1989.00520440064022. [DOI] [PubMed] [Google Scholar]
  6. Bromberg M. B. Comparison of electrodiagnostic criteria for primary demyelination in chronic polyneuropathy. Muscle Nerve. 1991 Oct;14(10):968–976. doi: 10.1002/mus.880141007. [DOI] [PubMed] [Google Scholar]
  7. Brown W. F., Feasby T. E. Conduction block and denervation in Guillain-Barré polyneuropathy. Brain. 1984 Mar;107(Pt 1):219–239. doi: 10.1093/brain/107.1.219. [DOI] [PubMed] [Google Scholar]
  8. Cartier L., Gálvez S., Gajdusek D. C. Familial clustering of the ataxic form of Creutzfeldt-Jakob disease with Hirano bodies. J Neurol Neurosurg Psychiatry. 1985 Mar;48(3):234–238. doi: 10.1136/jnnp.48.3.234. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. McLeod J. G. Electrophysiological studies in the Guillain-Barré syndrome. Ann Neurol. 1981;9 (Suppl):20–27. doi: 10.1002/ana.410090705. [DOI] [PubMed] [Google Scholar]
  10. Saida K., Saida T., Brown M. J., Silberberg D. H. In vivo demyelination induced by intraneural injection of anti-galactocerebroside serum: a morphologic study. Am J Pathol. 1979 Apr;95(1):99–116. [PMC free article] [PubMed] [Google Scholar]
  11. Sumner A. J. The physiological basis for symptoms in Guillain-Barré syndrome. Ann Neurol. 1981;9 (Suppl):28–30. doi: 10.1002/ana.410090706. [DOI] [PubMed] [Google Scholar]
  12. van der Meché F. G., Meulstee J., Kleyweg R. P. Current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol. 1991 Dec;30(6):851–852. doi: 10.1002/ana.410300618. [DOI] [PubMed] [Google Scholar]
  13. van der Meché F. G., Meulstee J., Vermeulen M., Kievit A. Patterns of conduction failure in the Guillain-Barré syndrome. Brain. 1988 Apr;111(Pt 2):405–416. doi: 10.1093/brain/111.2.405. [DOI] [PubMed] [Google Scholar]
  14. van der Meché F. G., Schmitz P. I. A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barré syndrome. Dutch Guillain-Barré Study Group. N Engl J Med. 1992 Apr 23;326(17):1123–1129. doi: 10.1056/NEJM199204233261705. [DOI] [PubMed] [Google Scholar]

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