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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(08): 481-487
DOI: 10.1590/0004-282X20200042
Original Article

The prognostic value of demyelinating electrophysiologic findings and cerebrospinal fluid protein levels in acute inflammatory demyelinating polyneuropathy

O valor prognóstico dos achados eletrofisiológicos desmielinizantes e os níveis de proteína do líquido cefalorraquidiano na polineuropatia desmielinizante inflamatória aguda
Abdulkadir TUNÇ 
1   Sakarya University, Sakarya Training and Research Hospital, Department of Neurology, Sakarya, Turkey.
,
Aysel TEKEŞİN 
2   Health Sciences University, Istanbul Training and Research Hospital, Department of Neurology, Istanbul, Turkey.
,
Vildan GÜZEL 
3   Bezmialem Vakif University, Faculty of Medicine, Department of Neurology, Istanbul, Turkey.
,
Yonca ÜNLÜBAŞ 
1   Sakarya University, Sakarya Training and Research Hospital, Department of Neurology, Sakarya, Turkey.
,
Meral SEFEROĞLU 
4   Bursa Yüksek İhtisas Education and Research Hospital, Department of Neurology, Bursa, Turkey.
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ABSTRACT

Background: Guillain-Barre syndrome is an acute immune-mediated polyneuropathy characterized by rapidly evolving symptoms and disability. Cerebrospinal fluid analysis and electrophysiological studies are crucial in the diagnosis of this syndrome. Objective: To evaluate the prognostic value of the type and number of demyelinating findings and cerebrospinal fluid protein levels in patients with acute inflammatory demyelinating polyneuropathy. Methods: We retrospectively analyzed electrophysiological data and cerebrospinal fluid of 67 consecutive patients with acute inflammatory demyelinating polyneuropathy from Istanbul, Turkey (2011-2019) studied ≤ 24 hours post-onset. Results: The patients who met a higher number of demyelinating criteria had increased disability scores in the first day and first month, and higher cerebrospinal fluid protein levels were correlated with worse prognosis both on the first day and the first month. However, the disability scores did not correlate with any single specific criterion, and no significant correlation was found between the number of satisfied criteria and cerebrospinal fluid protein levels. Conclusions: The number of demyelinating criteria that are met and high cerebrospinal fluid protein levels at the disease onset may be valuable prognostic markers. More systematic studies conducted with serial nerve conduction studies are required to highlight the roles of the suggested criteria in clinical practice.

RESUMO

Introdução: A síndrome de Guillain-Barré é uma polineuropatia imunomediada aguda caracterizada por sintomas e incapacidade em rápida evolução. A análise do líquido cefalorraquidiano e os estudos eletrofisiológicos são cruciais no diagnóstico dessa síndrome. Objetivo: Avaliar o valor prognóstico do tipo e número de achados desmielinizantes e dos níveis de proteínas do líquido cefalorraquidiano em pacientes com polineuropatia desmielinizante inflamatória aguda. Métodos: Analisamos retrospectivamente dados eletrofisiológicos e líquido cefalorraquidiano de 67 pacientes consecutivos com polineuropatia desmielinizante inflamatória aguda de Istambul, Turquia (2011-2019), estudados ≤24 horas após o início. Resultados: Os pacientes que atenderam a um número maior de critérios desmielinizantes apresentaram escores de incapacidade aumentados no primeiro dia e no primeiro mês, e níveis mais altos de proteína do líquido cefalorraquidiano foram correlacionados com pior prognóstico no primeiro dia e no primeiro mês. No entanto, os escores de incapacidade não se correlacionaram com nenhum critério específico e não foi encontrada correlação significativa entre o número de critérios satisfeitos e os níveis de proteína do líquido cefalorraquidiano. Conclusões: O número de critérios desmielinizantes atendidos e altos níveis de proteína no líquido cefalorraquidiano no início da doença podem ser marcadores prognósticos valiosos. Estudos mais sistemáticos conduzidos com estudos de condução nervosa em série são necessários para destacar os papéis dos critérios sugeridos na prática clínica.

Keywords:

Guillain-Barre Syndrome - Prognosis - Electromyography

Palavras-chave:

Síndrome de Guillain-Barré - Prognóstico - Eletromiografia

Authors’ contributions:

Study conception and design: Abdulkadir Tunç, Aysel Tekeşin, Vildan Güzel. Acquisition of data: Abdulkadir Tunç, Aysel Tekeşin, Vildan Güzel, Yonca Ünlübaş, Meral Seferoğlu. Analysis and interpretation of data: Aysel Tekeşin, Yonca Ünlübaş, Meral Seferoğlu. Drafting of manuscript: Abdulkadir Tunç. Critical revision: Abdulkadir Tunç, Aysel Tekeşin, Vildan Güzel, Yonca Ünlübaş, Meral Seferoğlu.




Publication History

Received: 06 April 2020

Accepted: 12 April 2020

Article published online:
13 June 2023

© 2020. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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