A-waves in Guillain-Barre syndrome: Correlation with electrophysiological subtypes and antiganglioside antibodies

作者：Kawakami Shingo; Sonoo Masahiro^*; Kadoya Akiko; Chiba Atsuro; Shimizu Teruo

来源：Clinical Neurophysiology, 2012, 123(6): 1234-1241.

DOI：10.1016/j.clinph.2011.10.005

• Guillain-Barre syndrome
• A-wave
• Acute inflammatory demyelinating polyradiculoneuropathy
• Anti-ganglioside antibodies

Objective: To investigate the relationship of A-waves with conventional electrophysiological subtypes of Guillain-Barre syndrome (GBS), as well as with anti-ganglioside antibodies. %26lt;br%26gt;Methods: The subjects consisted of 30 GBS patients who were classified into acute inflammatory demyelinating polyradiculoneuropathy (AIDP), acute motor axonal neuropathy, and unclassified based on the results of nerve conduction studies. %26quot;Abundant A-waves%26quot; were defined for the upper-limb nerves (median and ulnar nerves) using receiver-operator characteristic curves. The presence or absence of IgG antiganglioside antibodies was also noted. %26lt;br%26gt;Results: Abundant A-waves at weeks 3-6 from onset were observed in 64% of the 14 AIDP patients and 0% of 16 non-AIDP patients, and in 60% of 15 antibody-negative patients and 0% of 15 antibody-positive patients. In the earlier period, this relationship was less clear. The correlation between the conventional electrophysiological subtypes and antibodies was present, but was much weaker. %26lt;br%26gt;Conclusions: Abundant A-waves in GBS after the acute phase were strongly associated with demyelination that was not mediated by antiganglioside antibodies, possibly through the mechanism of proximal re-excitation induced by electrical inhomogeneities due to segmental demyelination. %26lt;br%26gt;Significance: Abundant A-waves are promising as a novel reliable marker of demyelination.

• 出版日期2012-6