Analysis Of Clinical Data And Electrophysiological Classification Of Guillain-barré Syndrome

Background GBS(Guillain-Barré syndrome, GBS) is an immune-mediated peripheral nerve disease with peripheral nerve and nerve root demyelination. According to the electrophysiological manifestation of patients with GBS, it can be divided into AIDP, Acute motor axonal neuropathy( AMAN), Acute motor axonal neuropathy(AMSAN), etc. Different Electrophysiological subtypes of some patients may change in progression of the disease, and some of the cases of patients with GBS performed conduction block(CB).It suggests demyelination is a major cause of lead to CB occurred conventionally, but in recent years, studies have shown that CB is more likely to be a result of the combined action of many factors such as demyelination and axonal membrane damaged and Na+ channel inactivation [1].In recent years there are many research about that clinical and electrophysiological classification changes in GBS cases,and prognosis of CB and outcome suggest that there is positive correlation between early electrophysiological changes with conduction block and GBS electrophysiological classification changes [2].Objective To investigate the electrophysiological characteristic in disease progression ofGuillain—Barre syndrome and observe the classification transformation and effect of conduction block in classification in the disease.Methods Patients with Guillain-Barre syndrome between 2008 to 2013 to research the clinical and electrophysiological characteristics according their electrophysiological result and reclassificate after electrophysiological review.Patients with Guillain-Barre syndrome in hospital between 2008 to 2013 divided into AIDP group, AMAN group and equivocal group according their electrophysiological result and reclassificate after electrophysiological review. All of the patients has been followed up 6 months later since their attack. 132 patients with Guillain-Barre syndrome which have verified at least 2 electrophysiological test be divided into AIDP group, AMAN group and equivocal group according their electrophysiological results and re-classification after electrophysiological review. The difference between the 1st and the 2nd classification in disease progression and the effect of conduction block for all patients have been investigated.Results Two hundred and ninety-four cases : Bad prognosis case in AMAN group is more than AIDP group( P<0.05). The dissociated sensory disturbance showed by EMG in GBS patients with typical clinical manifestations should confirmed the diagnosis of GBS.One hundred and thirty-two cases :There is classification transformation in disesase progression of patients with Guillain—Barre syndrome. There is a positive relationship between conduction block in early phase of the disease and alteration of classification :AIDP group: = 6.818,P = 0.009(P<0.05);unclassified group:=6.272,P = 0.012(P<0.05),There are statistical significance in AIDP group and unclassified group. There is a positive relationship between CB in the early phase of the disease and severity of illness in AIDP group: = 6.972,P = 0.008(P<0.05). 2c2c2cConclusionCB in the early phase of Guillain-Barre syndrome indicate the probability of AIDP trasform into AMAN; it suggests that patients with CB in the early phase of the disease might in serious condition in a certain extent, and electrophysiological review in different peirod of patients with Guillain-Barre syndrome is necessary.