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- Title
Multiple A waves in Guillain-Barré syndrome.
- Authors
Kornhuber, Malte E.; Bischoff, Christian; Mentrup, Heike; Conrad, Bastian; Kornhuber, M E; Bischoff, C; Mentrup, H; Conrad, B
- Abstract
In 13 of 14 patients with Guillain-Barré syndrome (GBS), we observed multiple A waves in at least one limb nerve on routine electroneurographic studies within 7 days after onset of symptoms. The patient without A waves had a severe axonal type of GBS with tetraplegia and almost complete loss of M responses following electrical stimulation of limb nerves. In the remaining 13 patients, on average 8 +/- 2 (mean +/- SD) A waves were present in each tibial nerve (n = 24) and 4 +/- 1 A waves in each peroneal nerve (n = 26). About half of the A waves were below 50 microV in amplitude, whereas amplitudes were higher than 120 microV in only 22 of 299 A waves. Of these A waves, 68 were not constantly elicitable. There was a significant correlation between the number of A waves up to 50 ms poststimulus and the reduction in amplitude of the compound muscle action potential when elicited with proximal compared to distal stimulation in the peroneal (n = 26, P < 0.0005; Kendall's tau) and tibial nerves (n = 24, P < 0.002). Therefore, in GBS both conduction block and A waves are presumably signs of inflammatory nerve lesions. The existence of multiple A waves soon after onset of symptoms seems to be a sensitive sign of GBS.
- Subjects
NEURAL physiology; NEUROPHYSIOLOGY; TIME; EXTREMITIES (Anatomy); REFLEXES; NEURAL conduction; ELECTROPHYSIOLOGY; GUILLAIN-Barre syndrome; ELECTRIC stimulation; QUADRIPLEGIA; MOTOR neurons; DISEASE complications
- Publication
Muscle & Nerve, 1999, Vol 22, Issue 3, p394
- ISSN
0148-639X
- Publication type
journal article
- DOI
10.1002/(SICI)1097-4598(199903)22:3<394::AID-MUS13>3.0.CO;2-V