Sural-sparing Pattern: A Study Against Electrodiagnostic Subtypes of Guillain-Barre Syndrome

Overview

Journal Clin Neurophysiol Pract

Publisher Elsevier

Specialty Neurology

Date 2022 Oct 17

PMID 36248727

Authors

Nath Pasutharnchat

Varis Ratanasirisawad

Manasawan Santananukarn

Chamaiporn Taychargumpoo

Jakkrit Amornvit

Chaipat Chunharas

Affiliations

Soon will be listed here.

Abstract

Objective: To study sural-sparing pattern in GuillainBarre syndrome (GBS) and compare it among GBS's electrodiagnostic subtypes, classified by two recent criteria.

Methods: This study retrospectively reviewed clinical data and electrodiagnostic studies (EDXs) of 88 GBS patients diagnosed in a tertiary care hospital (2010-2019).

Results: Overall, 79/88 (89.8%) and 36/45 (80%) patients had bilateral sensory nerve conduction studies (NCS) in the first EDX and follow-up EDX, respectively. Sural-sparing occurred in all subtypes (50% overall occurrence rate), most commonly in demyelination. There was no statistically significant difference in sural-sparing occurrence rates between demyelinating and axonal GBS; however, sural-sparing in axonal GBS tended to show a lower number of abnormal upper-limb sensory nerve action potentials (SNAPs) than demyelinating GBS. Shifting between sural-sparing and no sural-sparing occurred in approximately-one-fourth of patients receiving serial studies. Follow-up EDX additionally discovered 20% of all sural-sparing. Unilateral EDX could have omitted up to 30% of sural-sparing.

Conclusions: Sural-sparing is less obviously manifested in axonal than demyelinating GBS, with respect to the number of affected upper-limb SNAPs. Extended sensory NCS is worth in detecting sural-sparing as a supportive electrodiagnostic GBS feature.

Significance: This report showed one different character of sural-sparing (number of affected upper-limb SNAPs) between demyelinating and axonal GBS.

Citing Articles

Molecular, Electrophysiological, and Ultrasonographic Differences in Selected Immune-Mediated Neuropathies with Therapeutic Implications.

Dziadkowiak E, Nowakowska-Kotas M, Ralowska-Gmoch W, Budrewicz S, Koszewicz M Int J Mol Sci. 2023; 24(11).

PMID: 37298132 PMC: 10252615. DOI: 10.3390/ijms24119180.

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