길랭-바레 증후군의 전기진단

Abstract

Electrophysiologic examination is important for diagnosis of Guillain-Barre syndrome (GBS), classification of its subtypes, and establishment of prognosis. There were many electrodiagnostic criteria sets for demyelinating type of GBS, acute inflammatory demyelinating polyneuropathy, with different sensitivity and specificity. Criteria sets for axonal type of GBS, acute motor axonal neuropathy (AMAN) and acute motor and sensory axonal neuropathy, were initially proposed based on the simple axonal degeneration. However, some patients with AMAN demonstrated transient conduction block/slowing in intermediate and distal nerve segments without abnormal temporal dispersion, which named reversible conduction failure (RCF). The lack of difference between demyelinating conduction block and RCF could lead to falsely classify AMAN patients with RCF as AIDP or AMAN with axonal degeneration. Serial electrophysiological studies are mandatory for the proper classification of GBS subtypes. Also, more appropriate electrodiagnostic criteria set for the axonal GBS should be developed.