Sural-sparing is seen in axonal as well as demyelinating forms of Guillain-Barré syndrome

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
Thirugnanam UmapathiNobuhiro Yuki

Abstract

The "sural-sparing pattern" of Guillain-Barré syndrome (GBS) is believed to reflect demyelinating pathology. We asked if it is present in non-demyelinating GBS-subtypes, namely acute motor axonal neuropathy (AMAN), acute motor-sensory axonal neuropathy (AMSAN) and Miller Fisher syndrome (MFS), in addition to acute inflammatory demyelinating polyneuropathy (AIDP). We studied the occurrence of sural-sparing pattern in clinically defined GBS and MFS patients. Using serial electrodiagnostic studies, GBS patients were divided into AIDP, according to appearance of demyelination-remyelination and AMAN/AMSAN, if there were signs of reversible conduction failure or Wallerian-like degeneration. Equivocal cases were left unclassified. We defined sural-sparing as a greater decrease in median and or ulnar sensory nerve action potential than that of the sural, compared to age and height-matched normal controls. Twelve of 30 GBS and 7 of 20 MFS patients had sural-sparing. This pattern was seen in 4 of 8 AIDP, 5 of 13 AMAN/AMSAN and 3 of 9 unclassified cases. Sequential studies uncovered sural-sparing, initially covert, in additional 1 MFS, 1 unclassified, 1 AIDP and 1 AMAN/AMSAN patient. Sural-sparing occurs in axonal and demyelinating GBS su...Continue Reading

References

May 10, 2005·Muscle & Nerve·Amer Al-ShekhleeBashar Katirji
Sep 22, 2010·Brain : a Journal of Neurology·Norito KokubunNobuhiro Yuki
Jul 4, 2012·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Antonino Uncini, Satoshi Kuwabara
Jul 7, 2012·Journal of Neurology, Neurosurgery, and Psychiatry·Thirugnanam UmapathiNobuhiro Yuki
Mar 12, 2013·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Yukari SekiguchiSatoshi Kuwabara
Mar 13, 2014·Muscle & Nerve·Angelika DerksenHelmar C Lehmann

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Citations

Oct 16, 2015·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Fu Liong Hiew, Yusuf A Rajabally
May 12, 2015·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Thirugnanam UmapathiNobuhiro Yuki
May 13, 2015·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·José Berciano, Antonio García
May 24, 2015·Clinical Neurology and Neurosurgery·Marco LuigettiMauro Lo Monaco
Dec 29, 2020·Neuroscience Letters·Kathryn R MossAhmet Höke
Mar 30, 2021·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Joumana FreihaRechdi Ahdab
Jul 8, 2021·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Andrea RaseraGiovanna Squintani

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