伊斯坦布尔验证吉兰-巴雷综合征亚型的电诊断方法:前瞻性多中心研究。

IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Journal of the Peripheral Nervous System Pub Date : 2024-01-30 DOI:10.1111/jns.12612
Volkan Tasdemir, Nermin Gorkem Sirin, Arman Cakar, Ayla Culha, Aysun Soysal, Ayse Deniz Elmali, Aysegul Gunduz, Beyza Arslan, Destina Yalcin, Dilek Atakli, Elif Kocasoy Orhan, Elif Sanli, Erdem Tuzun, Eren Gozke, Esra Gursoy, Feray Karaali Savrun, Ferda Ilgen Uslu, Fikret Aysal, Hacer Durmus, Hafsa Bulbul, F. Inci Ertas, Kayihan Uluc, Kemal Tutkavul, Leyla Baysal, Mehmet Baris Baslo, Meral Kiziltan, Metin Mercan, Nevin Pazarci, Nurten Uzun, Onur Akan, Ozlem Cokar, Pinar Kahraman Koytak, Reyhan Sürmeli, Sefer Gunaydin, Selahattin Ayas, Sezin Alpaydin Baslo, Vildan Yayla, Vuslat Yilmaz, Yesim Parman, Zeliha Matur, Zeynep Unlusoy Acar, Ali Emre Oge
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引用次数: 0

摘要

背景与目的本研究旨在确定伊斯坦布尔吉兰-巴雷综合征(GBS)的临床特征和电诊断亚型:方法:在 2019 年 4 月至 2022 年 3 月期间前瞻性地招募了 GBS 患者,并为每位患者进行了两次电诊断检查。比较了 Ho 等人、Hadden 等人、Rajabally 等人和 Uncini 等人区分脱髓鞘亚型和轴索亚型的标准,并分析了它们与抗神经节苷脂抗体的关系:结果:共纳入177例患者,其中69例在2019年冠状病毒病大流行前(2019年4月至2020年2月),108例在大流行期间(2020年3月至2022年3月),每月频率无重大变化。与 Uncini 等人的标准相比,根据 Ho 等人和 Hadden 等人的标准(分别为 95/162 例,58.6%;110/174 例,63.2%;121/174 例,69.5%)诊断出脱髓鞘性 GBS 亚型的频率更高,而根据 Rajabally 等人的标准(76/174 例,43.7%)诊断出脱髓鞘性 GBS 亚型的频率较低。根据 Rajabally 等人的标准,有 14 名患者在第二次电诊断检查时被诊断为其他亚型。在106名被分析的患者中,22人有免疫球蛋白G抗神经节苷脂抗体(14人为轴索亚型)。与无抗体患者相比,他们的感觉症状较少(54.5% 对 83.1%,P = 0.009),既往胃肠炎病史较多(54.5% 对 22.9%,P = 0.007),病情较重:解读:由于该病的病理生理学是动态的,因此连续的电诊断检查更有助于准确诊断 GBS 的亚型。我们观察到,在大流行期间,该城市的 GBS 发病率没有明显增加。
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Electrodiagnostic methods to verify Guillain-Barré syndrome subtypes in Istanbul: A prospective multicenter study

Background and Aims

This study aimed to identify the clinical characteristics and electrodiagnostic subtypes of Guillain-Barré syndrome (GBS) in Istanbul.

Methods

Patients with GBS were prospectively recruited between April 2019 and March 2022 and two electrodiagnostic examinations were performed on each patient. The criteria of Ho et al., Hadden et al., Rajabally et al., and Uncini et al. were compared for the differentiation of demyelinating and axonal subtypes, and their relations with anti-ganglioside antibodies were analyzed.

Results

One hundred seventy-seven patients were included, 69 before the coronavirus disease 2019 pandemic (April 2019–February 2020) and 108 during the pandemic (March 2020–March 2022), without substantial changes in monthly frequencies. As compared with the criteria of Uncini et al., demyelinating GBS subtype diagnosis was more frequent according to the Ho et al. and Hadden et al. criteria (95/162, 58.6% vs. 110/174, 63.2% and 121/174, 69.5%, respectively), and less frequent according to Rajabally et al.'s criteria (76/174, 43.7%). Fourteen patients' diagnoses made using Rajabally et al.'s criteria were shifted to the other subtype with the second electrodiagnostic examination. Of the 106 analyzed patients, 22 had immunoglobulin G anti-ganglioside antibodies (14 with the axonal subtype). They had less frequent sensory symptoms (54.5% vs. 83.1%, p = 0.009), a more frequent history of previous gastroenteritis (54.5% vs. 22.9%, p = 0.007), and a more severe disease as compared with those without antibodies.

Interpretation

Serial electrodiagnostic examinations are more helpful for accurate subtype diagnosis of GBS because of the dynamic pathophysiology of the disease. We observed no significant increase in GBS frequency during the pandemic in this metropolis.

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来源期刊
CiteScore
6.10
自引率
7.90%
发文量
45
审稿时长
>12 weeks
期刊介绍: The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders. The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies. Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials. The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.
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