J Korean Neurol Assoc > Volume 20(6); 2002 > Article

Journal of the Korean Neurological Association 2002;20(6): 630-633.

"길랑-바레 증후군의 전기생리학적 분류 -전기생리학적 소견의 시기적 변화 -"

신진홍, 최광동 김대성 정대수 박규현

부산대학교 의과대학 신경과학교실

"Electrophysiological Classification of Guillain-Barre Syndrome - Sequential Changes in Electrophysiologic Findings-"

Jin Hong Shin

Department of Neurology, College of Medicine, Pusan National University

Abstract

"Background : Guillain-Barre syndrome (GBS) is subclassified into acute inflammatory demyelinating polyneuropa-thy, acute motor or motor-sensory axonal neuropathy, and the other variants. While most studies from Western coun-tries report demyelinating type as predominant form of GBS, some reports from Asian countries suggest the opposite result. Because they are not easily discriminated clinically, electrophysiological study is the most practical method for their subclassification. Methods : Among the patients who had been admitted to our hospital with typical clinical fea-tures of GBS over the past 4 years, we analyzed 32 patients, who had undergone at least 2 serial nerve conduction stud-ies (NCS) throughout the course. In each case, conventional NCS in at least 3 limbs were performed and the criteria of Hadden et al., and 2 other criteria were applied. Results : Using the criteria of Hadden et al., 91% of the patients were classified as primary demyelination, and none as primary axonal pathology. Among the cases of primary demyelination, 21% showed electrophysiological features of axonal GBS at least in one occasion during the serial studies. Conclusions : Our study suggests that the primary demyelinating type is by far more predominant in our population. Secondary changes of electrophysiological findings in some of our cases suggest that primary demyelination could be misinterpret-ed as primary axonal pathology without timely serial studies. For the epidemiologic study of larger scale in conjunction with clinical features and immunologic investigations, the protocol and criteria of consensus is necessary, with the qual-ified normal limit values of each laboratory."