Comparison of ulnar, median, and sural sensory nerve conduction studies between demyelinating and axonal forms of Guillain-Barré Syndrome

Year 2023, Volume: 4 Issue: 2, 70 - 77, 31.05.2023

Mehmet Yıldız , Halit Fidancı , Gülçin Ortaç , Şencan Buturak , Zülfikar Arlıer

https://doi.org/10.47482/acmr.1170798

Abstract

Background: Guillain-Barré syndrome (GBS) is an important neurological disease that can cause disability. Axonal GBS and acute inflammatory demyelinating polyradiculoneuropathy (AIDP) are two important subgroups.
Methods: Patients with clinical and electrodiagnostic features compatible with GBS were included in this retrospective study. The patients were divided into two groups neurophysiologically as Axonal GBS and AIDP. Medical research council (MRC) scores of the patients' muscles, median / ulnar / posterior tibial / peroneal / sural nerve conduction study findings were included in the analyses. Sural sparing pattern was considered as the absence of median/ulnar compound nerve action potential (CNAP) and present sural nerve CNAP (SS-M/SS-U).
Results: Twelve AIDP and 10 Axonal GBS patients were included in the study. MRC scores were not different between the two groups (p=0.895). CNAPs of the right median and ulnar nerves were smaller in AIDP patients than in Axonal GBS patients (p<0.001, p=0.004). CNAPs of the right and left sural nerves were not different between the two groups (p=0.140, p=0.099). SS-M / SS-U was observed in 1(10%)/1(10%) and 6(50%)/4(33%) of axonal GBS and AIDP patients, respectively (p=0.074 for SS-M, p =0.323 for SS-U). There was a positive correlation between right median / ulnar nerve CNAP amplitudes and sural nerve CNAP amplitude (p=0.003 r=0.623 / p<0.001 r=0.850).
Conclusion: This study showed that the sural nerve conduction study findings may not be different in axonal GBS and AIDP patients. There may be a relationship between CNAPs of median/ulnar nerves and CNAPs of sural nerves.

Keywords

Acute inflammatory demyelinating polyradiculoneuropathy, Guillain-Barré syndrome, Sensory nerve conduction study, Sural sparing

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