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. 2026 Feb 8.
doi: 10.1002/mus.70152. Online ahead of print.

Dynamics of Nerve Conduction Studies in Patients With Guillain-Barré Syndrome

Samuel Arends  1   2 , Laura de Koning  2 , Judith Drenthen  2 , Mahova Zhu  2 , Peter Y K van den Bergh  3 , Robert M Hadden  4 , Nortina Shahrizaila  5 , Ricardo C Reisin  6 , Satoshi Kuwabara  7 , Senda Ajroud-Driss  8 , Giovanni Antonini  9 , Claudia Balducci  10 , Fabio A Barroso  6 , Thomas H Brannagan  11 , Jan Buermann  12 , Carlos Casasnovas  10 , Guido Cavaletti  13 , Chi-Chao Chao  14 , Ulrich Dillmann  12 , Mazen M Dimachkie  15 , Giuliana Galassi  16 , Gerardo Gutiérrez-Gutiérrez  17   18 , Thomas Harbo  19 , Sung-Tsang Hsieh  14 , Badrul Islam  20 , Hans Katzberg  21 , Lynette Kiers  22 , Giorgia Mataluni  23 , Julio Pardo  24 , Yann Peréon  25 , Yusuf A Rajabally  26 , Mark Stettner  27 , Camiel Verhamme  28 , Michal Vytopil  29 , Waheed Waqar  30 , David R Cornblath  31 , Bart C Jacobs  2   32 ; IGOS Consortium
Collaborators, Affiliations

Dynamics of Nerve Conduction Studies in Patients With Guillain-Barré Syndrome

Samuel Arends et al. Muscle Nerve. .

Abstract

Introduction/aims: The value of electrodiagnostic subtyping of Guillain-Barré syndrome (GBS) is still debated. This study aimed to determine the diagnostic yield, timing, and changes of the electrodiagnostic subtyping in patients with GBS in serial nerve conduction studies (NCS).

Methods: Data were extracted from the International GBS Outcome Study (IGOS) database. Serial NCS were available for 469 patients. For the serial NCS analysis, the intervals between the first and second study were defined as ≥ 7 and ≤ 42 days after onset of weakness. All NCS were classified according to the electrodiagnostic criteria sets of Hadden et al. and Rajabally et al.

Results: In NCS conducted within 3 days of onset of weakness, an axonal or demyelinating subtype could be demonstrated in 58.4% (Hadden) and 52.1% (Rajabally). NCS performed at a later timepoint demonstrated a similar yield of axonal and demyelinating subtypes. In patients with motor-sensory and motor GBS, the electrodiagnostic subtype changed on serial NCS in 37.8% (Hadden) and 44.7% (Rajabally). As the subtypes changed in multiple and opposite directions, the total proportion of axonal and demyelinating subtypes remained stable across time points. In patients with motor GBS, both axonal and demyelinating subtypes were found.

Discussion: This study demonstrates the highly dynamic disease course of GBS. The role of NCS remains to support the clinical diagnosis of GBS and should be performed as quickly as possible after onset of weakness. If these early NCS are non-diagnostic, repeating the study should be considered. Electrodiagnostic subtyping offers no additional value.

Keywords: AIDP; EMG; Guillain–Barré syndrome; nerve conduction study; polyneuropathy.

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References

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