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- Title
Very low peroneal nerve compound muscle action potential amplitude predicts poor outcome in patients with Guillain-Barré syndrome: a prospective cohort.
- Authors
López-Hernández, Juan Carlos; Galnares-Olalde, Javier Andrés; Jorge de Saráchaga, Adib; Briseño-Godínez, María Eugenia; Pérez-Valdez, Esther; May-Mas, Raúl Nathanael; Arista-Ramírez, José Luis; Bazán-Rodríguez, Lisette; León-Manriquez, Elizabeth; Burgos-Centeno, Jorge; Vargas-Cañas, Edwin Steven
- Abstract
<bold>Introduction: </bold>Twenty percent of patients with Guillain-Barré syndrome (GBS) have poor outcomes despite proper management. The aim of the study was to characterize electrophysiological factors related to poor outcome in patients with GBS.<bold>Methods: </bold>We conducted an observational study from a prospective cohort of 91 patients with GBS in a tertiary healthcare center in Mexico, from 2017 to 2019. Demographics and nerve conduction studies were performed on admission, and a 3-month follow-up for GBS disability score was ensued, allocating patients in good (GBS disability score ≤ 2) and poor outcome (GBS disability score ≥ 3) groups. A logistic regression analysis for independent walk at 3 months was performed. Kaplan-Meier estimator curves for independent walk in very low (< 20% LLN) and low-normal ( ≥20% LLN) peroneal nerve CMAPs are presented.<bold>Results: </bold>From the 91 GBS patients included, 37 (40.6%) did not regain independent walk at 3 months. Axonal variants were more common in the poor outcome group (31.4% vs 59.4%, p = 0.01) as well as AIDP variants with motor conduction block (6.6% vs 42.4%, p = 0.018). Univariable analysis was statistically significant for very low median, ulnar, tibial, and peroneal CMAP amplitudes in poor outcome patients; however, multivariable analysis was only significant for very low peroneal nerve CMAP amplitude (OR 3.6 [1.1-11.5, p = 0.024]). Conversely, a greater proportion of GBS patients with low-normal CMAPs recovered independent walk at 90 days (75% vs 30%, p < 0.001).<bold>Conclusion: </bold>Severe axonal injury of the peroneal nerve, axonal, and AIDP with motor conduction block variants predicts worse functional outcome regarding independent walk at 3 months.
- Subjects
MEXICO; ACTION potentials; GUILLAIN-Barre syndrome; TREATMENT effectiveness; LOGISTIC regression analysis; KAPLAN-Meier estimator; PERONEAL nerve; PERONEAL tendons; MUSCLES; NEURAL conduction; LONGITUDINAL method
- Publication
Neurological Sciences, 2022, Vol 43, Issue 6, p3923
- ISSN
1590-1874
- Publication type
journal article
- DOI
10.1007/s10072-021-05834-7