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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1996 Feb;60(2):191–194. doi: 10.1136/jnnp.60.2.191

Respiratory electrophysiological studies in Guillain-Barré syndrome.

U Zifko 1, R Chen 1, H Remtulla 1, A F Hahn 1, W Koopman 1, C F Bolton 1
PMCID: PMC1073803  PMID: 8708652

Abstract

Respiratory failure is a common and potentially life threatening complication in patients with Guillain-Barré syndrome. The incidence of phrenic nerve involvement and the predictive value of phrenic nerve conduction and diaphragmatic needle EMG were studied in 40 patients with Guillain-Barré syndrome within the first three days of admission to hospital. The negative peak onset latency of the diaphragmatic compound muscle action potential (CMAP), and its amplitude, duration, and area were abnormal in 83%. The need for ventilation was correlated with diaphragmatic CMAP amplitude (P = 0.005), and area (P = 0.001), but not with latency or duration. Abnormalities in diaphragmatic needle EMG were found in 45%, mainly a decreased number of motor unit potentials. The abnormalities correlated with the need for ventilation (P = 0.013). Of the 40% who required ventilation, all had either abnormal phrenic conduction, abnormal diaphragmatic needle EMG, or both. Eighty one per cent of the ventilated patients had abnormal forced vital capacity on the day of the electrophysiological examination. The results indicate that phrenic nerve conduction studies and diaphragmatic EMG are useful in detecting respiratory involvement in patients with Guillain-Barré syndrome and in identifying those at risk of respiratory failure.

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Selected References

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

  1. Bolton C. F. AAEM minimonograph #40: clinical neurophysiology of the respiratory system. Muscle Nerve. 1993 Aug;16(8):809–818. doi: 10.1002/mus.880160802. [DOI] [PubMed] [Google Scholar]
  2. Bolton C. F., Grand'Maison F., Parkes A., Shkrum M. Needle electromyography of the diaphragm. Muscle Nerve. 1992 Jun;15(6):678–681. doi: 10.1002/mus.880150608. [DOI] [PubMed] [Google Scholar]
  3. 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]
  4. Chen R., Collins S., Remtulla H., Parkes A., Bolton C. F. Phrenic nerve conduction study in normal subjects. Muscle Nerve. 1995 Mar;18(3):330–335. doi: 10.1002/mus.880180311. [DOI] [PubMed] [Google Scholar]
  5. Cornblath D. R., Mellits E. D., Griffin J. W., McKhann G. M., Albers J. W., Miller R. G., Feasby T. E., Quaskey S. A. Motor conduction studies in Guillain-Barré syndrome: description and prognostic value. Ann Neurol. 1988 Apr;23(4):354–359. doi: 10.1002/ana.410230407. [DOI] [PubMed] [Google Scholar]
  6. Davis J. N. Phrenic nerve conduction in man. J Neurol Neurosurg Psychiatry. 1967 Oct;30(5):420–426. doi: 10.1136/jnnp.30.5.420. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Feasby T. E., Brown W. F., Gilbert J. J., Hahn A. F. The pathological basis of conduction block in human neuropathies. J Neurol Neurosurg Psychiatry. 1985 Mar;48(3):239–244. doi: 10.1136/jnnp.48.3.239. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Feasby T. E., Gilbert J. J., Brown W. F., Bolton C. F., Hahn A. F., Koopman W. F., Zochodne D. W. An acute axonal form of Guillain-Barré polyneuropathy. Brain. 1986 Dec;109(Pt 6):1115–1126. doi: 10.1093/brain/109.6.1115. [DOI] [PubMed] [Google Scholar]
  9. Gourie-Devi M., Ganapathy G. R. Phrenic nerve conduction time in Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry. 1985 Mar;48(3):245–249. doi: 10.1136/jnnp.48.3.245. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hughes R. A., Bihari D. Acute neuromuscular respiratory paralysis. J Neurol Neurosurg Psychiatry. 1993 Apr;56(4):334–343. doi: 10.1136/jnnp.56.4.334. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. McKhann G. M., Griffin J. W., Cornblath D. R., Mellits E. D., Fisher R. S., Quaskey S. A. Plasmapheresis and Guillain-Barré syndrome: analysis of prognostic factors and the effect of plasmapheresis. Ann Neurol. 1988 Apr;23(4):347–353. doi: 10.1002/ana.410230406. [DOI] [PubMed] [Google Scholar]
  12. Morris J. F., Koski A., Johnson L. C. Spirometric standards for healthy nonsmoking adults. Am Rev Respir Dis. 1971 Jan;103(1):57–67. doi: 10.1164/arrd.1971.103.1.57. [DOI] [PubMed] [Google Scholar]
  13. Ropper A. H., Kehne S. M. Guillain-Barré syndrome: management of respiratory failure. Neurology. 1985 Nov;35(11):1662–1665. doi: 10.1212/wnl.35.11.1662. [DOI] [PubMed] [Google Scholar]
  14. Winer J. B., Hughes R. A., Osmond C. A prospective study of acute idiopathic neuropathy. I. Clinical features and their prognostic value. J Neurol Neurosurg Psychiatry. 1988 May;51(5):605–612. doi: 10.1136/jnnp.51.5.605. [DOI] [PMC free article] [PubMed] [Google Scholar]

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