Abstract
OBJECTIVE
To ascertain the impact of definition and diagnostic criteria on sural sparing in Guillain-Barré syndrome (GBS).
METHODS
We retrospectively reviewed records of 78 consecutive patients with GBS from Birmingham, UK (2001-2012) studied within 21 days post-onset. Different criteria were initially used for subtype classification. Sural sparing was subsequently ascertained using historical/recent definitions.
RESULTS
With Hadden et al.'s criteria, "absent median present sural" and "absent median normal sural" patterns offered sensitivities of 21.7% and 15.2% respectively for AIDP, with specificities of 100% versus axonal GBS. Present sural with two abnormal upper limb responses had a sensitivity of 19.1% and 100% specificity. "Abnormal radial present sural" and "abnormal radial normal sural" patterns had sensitivities of 18.9% and 16.2% and specificity of 100%. With newly-proposed criteria (Rajabally et al., 2015), "absent median present sural" and "absent median normal sural" patterns offered sensitivities of 27.8% and 19.4% respectively, with specificity of 100%. Ulnar patterns were unhelpful with both criteria. Other patterns had suboptimal specificity.
CONCLUSION
Although of low sensitivity, sural sparing defined by absent median/present sural patterns, is specific of AIDP versus axonal GBS, irrespective of criteria.
SIGNIFICANCE
Sural sparing is definition and criteria-dependent in GBS but is specific of AIDP with historical definitions, regardless of criteria.
TY - JOUR
T1 - Sural sparing in Guillain-Barré syndrome subtypes: a reappraisal with historical and recent definitions.
AU - Hiew,Fu Liong,
AU - Rajabally,Yusuf A,
Y1 - 2015/09/30/
PY - 2015/05/17/received
PY - 2015/09/02/revised
PY - 2015/09/21/accepted
PY - 2015/10/14/entrez
PY - 2015/10/16/pubmed
PY - 2016/6/23/medline
KW - Acute inflammatory demyelinating polyradiculoneuropathy
KW - Axonal
KW - Electrophysiology
KW - Guillain–Barré syndrome
KW - Median
KW - Radial
KW - Sparing
KW - Sural
KW - Ulnar
SP - 1683
EP - 1688
JF - Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
JO - Clin Neurophysiol
VL - 127
IS - 2
N2 - OBJECTIVE: To ascertain the impact of definition and diagnostic criteria on sural sparing in Guillain-Barré syndrome (GBS). METHODS: We retrospectively reviewed records of 78 consecutive patients with GBS from Birmingham, UK (2001-2012) studied within 21 days post-onset. Different criteria were initially used for subtype classification. Sural sparing was subsequently ascertained using historical/recent definitions. RESULTS: With Hadden et al.'s criteria, "absent median present sural" and "absent median normal sural" patterns offered sensitivities of 21.7% and 15.2% respectively for AIDP, with specificities of 100% versus axonal GBS. Present sural with two abnormal upper limb responses had a sensitivity of 19.1% and 100% specificity. "Abnormal radial present sural" and "abnormal radial normal sural" patterns had sensitivities of 18.9% and 16.2% and specificity of 100%. With newly-proposed criteria (Rajabally et al., 2015), "absent median present sural" and "absent median normal sural" patterns offered sensitivities of 27.8% and 19.4% respectively, with specificity of 100%. Ulnar patterns were unhelpful with both criteria. Other patterns had suboptimal specificity. CONCLUSION: Although of low sensitivity, sural sparing defined by absent median/present sural patterns, is specific of AIDP versus axonal GBS, irrespective of criteria. SIGNIFICANCE: Sural sparing is definition and criteria-dependent in GBS but is specific of AIDP with historical definitions, regardless of criteria.
SN - 1872-8952
UR - https://www.unboundmedicine.com/medline/citation/26459671/Sural_sparing_in_Guillain_Barré_syndrome_subtypes:_a_reappraisal_with_historical_and_recent_definitions_
DB - PRIME
DP - Unbound Medicine
ER -
