Early Electro diagnostic Findings of Guillain Barre Syndrome: Case Series

Abstract

Introduction: Guillain Barre Syndrome (GBS) is an acute immune mediated de-mylelinating
poly-radiculo-neuropathy. As early diagnosis favors a good outcome after treatment, this study
was carried out to analyze the electro-physiological abnormalities in the first week of GBS in
this region. Case presentation: The study was carried out for early confirmation of GBS in 65
clinically diagnosed patients reporting within a week of muscle weakness by electrophysiological
tests in the years 2010-12. Conclusion: Slowing of motor conduction velocities,
decreased amplitude and increased distal motor latencies (DML) was seen in peroneal, tibial,
median and ulnar nerves in descending order of severity. Conduction block was seen in the lower
limb in 10 (15.38%) patients. F-wave was completely absent in upper and lower limbs in 50
(76.92%) patients while 15 patients (23.07%) showed decreased F-wave conduction velocity in
both limbs. Sensory conduction velocity of median nerve was less compared to sural nerve.
Electromyography (EMG) studies showed that de-myelinating type of neuropathy was
predominant (83.33%). Electro-physiological studies play an important role in the early
detection; characterization & treatment of GBS because timely intervention reduces morbidity
and disability. Increased DML, absent F- wave, decreased median with normal Sural SCV
(sensory conduction velocity) is diagnostic of early GBS.