Sorry about that
[QUOTE=sylvia’85]Hey Dan, the NCBI links wouldn’t come up for me. What were the titles of the articles you found?
Ali- I just sent you a PM:)[/QUOTE]
: Muscle Nerve. 2005 Jan;31(1):70-7. Related Articles, Links
Electrophysiological signs of permanent axonal loss in a follow-up study of patients with Guillain-Barré syndrome.
Dornonville de la Cour C, Andersen H, Stålberg E, Fuglsang-Frederiksen A, Jakobsen J.
Department of Neurology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark. [email]lacour@akhphd.au.dk[/email]
The neurophysiological mechanisms for persisting impairment of motor function after Guillain-Barre syndrome (GBS) were assessed in 37 unselected patients 1-13 years after diagnosis. For evaluation of reinnervation and axonal loss, macroelectromyography (macro-EMG) including measurement of fiber density (FD) was performed. Data from neuropathy symptom score, neuropathy disability score, nerve conduction studies, and quantitative sensory examination were ranked and summed to a neuropathy rank sum score (NRSS). The isokinetic muscle strength at the ankle was measured. Signs of axonal loss with increase of either macro motor unit potential (macro-MUP) amplitude or FD occurred in 76% of patients. The macro-MUP amplitude correlated with muscle strength and with NRSS. Patients with evidence of residual neuropathy had increased macro-MUP amplitude and FD as well as decreased muscle strength compared to patients without evidence of residual neuropathy. We conclude that axonal loss takes place in a substantial number of GBS patients and is associated with permanent muscle weakness caused by insufficient reinnervation. Possible patterns of pathology are discussed in relation to the macro-EMG findings.
PMID: 15543551 [PubMed – indexed for MEDLINE]
1: Neurology. 2005 Jan 25;64(2):246-53. Related Articles, Links
Residual neuropathy in long-term population-based follow-up of Guillain-Barré syndrome.
Dornonville de la Cour C, Jakobsen J.
Department of Neurology, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C, Denmark. [email]lacour@akhphd.au.dk[/email]
OBJECTIVE: To estimate the occurrence of residual neuropathy and its self-reported health consequences in a population-based group of patients with Guillain-Barré syndrome (GBS) and to characterize quantitatively the concomitant motor, sensory, and autonomic impairments. METHODS: Forty patients (mean age 46 years) with a confirmed diagnosis of GBS were studied a mean of 7 years (range 1 to 13 years) after the acute attack together with 40 healthy control subjects. The Dyck minimal criteria of neuropathy, the Neuropathy Symptom Score, the Neuropathy Disability Score, the Short Form-36 (SF-36) generic health questionnaire, isokinetic dynamometry at ankle and wrist, quantitative sensory testing of thresholds for vibration, cold, and pain, autonomic function tests, nerve conduction studies, and a summed Neuropathy Rank Sum Score (NRSS) were applied. RESULTS: Nineteen patients (48%) had residual neuropathy, which was independent of follow-up time. The patients with GBS reported lower health status than control subjects on the SF-36 Physical Component Summary Scale (PCS; p = 0.01), and the PCS scores correlated with the NRSS (r = -0.41, p = 0.009). In patients with GBS, muscle strength at ankle dorsal flexion was reduced by 13.9% (p = 0.001), sensory thresholds for vibration were increased in the foot (p < 0.05), and sensory thresholds for cold were increased in the hand and foot (p < 0.05), whereas autonomic functions and pain thresholds were unaffected. CONCLUSIONS: Residual neuropathy affecting large- and medium-sized myelinated fibers endures long after the acute attack of Guillain-Barré syndrome in approximately half of all patients, leads to motor and sensory dysfunction, and shows a trend toward impairing self-reported physical health status. PMID: 15668421 [PubMed - indexed for MEDLINE]