Abstract Objective To study the association of motor nerve conduction block (CB) with different subtypes of childhood Guillain-Barré syndrome (GBS). Methods A retrospective analysis was performed on the clinical and nerve electrophysiological data of 50 children with GBS. According to the results of nerve electrophysiology, the children were divided into an acute inflammatory demyelinating polyneuropathy (AIDP) group with 29 children and an acute motor axonal neuropathy (AMAN) group with 21 children. According to the presence or absence of motor nerve CB, the children with AMAN or AIDP were further divided into subgroups:group AMAN with or without motor nerve CB (n=10 and 11 respectively) and group AIDP with or without motor nerve CB group (n=19 and 10 respectively). The subgroups were compared in terms of age of onset, sex, Hughes Functional Grading Scale (HFGS) at nadir for the most severe involvement of motor function, and short-term prognosis based on HFGS score at 1 month after disease onset. Results Motor nerve CB was reversible in children with AMAN. AMAN children with motor nerve CB had a significantly lower HFGS score than those without motor nerve CB at 1 month after onset (P < 0.05). AIDP children with motor nerve CB had a significantly higher HFGS score than those with motor nerve CB at 1 month after onset (P < 0.05). Conclusions AMAN with reversible motor nerve CB suggests mild nerve fiber lesion and has better recovery than AMAN and AIDP without motor nerve CB in short term.
SUN Rui-Di,JIANG Jun,LIU Zhi-Sheng. Association of motor nerve conduction block with different subtypes of childhood Guillain-Barré syndrome[J]. CJCP, 2020, 22(9): 970-974.
SUN Rui-Di,JIANG Jun,LIU Zhi-Sheng. Association of motor nerve conduction block with different subtypes of childhood Guillain-Barré syndrome[J]. CJCP, 2020, 22(9): 970-974.
Estrade S, Guiomard C, Fabry V, et al. Prognostic factors for the sequelae and severity of Guillain-Barré syndrome in children[J]. Muscle Nerve, 2019, 60(6):716-723.
Rajabally YA, Hiew FL. Optimizing electrodiagnosis for Guillain-Barré syndrome:clues from clinical practice[J]. Muscle Nerve, 2017, 55(5):748-751.
[5]
Kokubun N, Nishibayashi M, Uncini A, et al. Conduction block in acute motor axonal neuropathy[J]. Brain, 2010, 133(10):2897-2908.
[6]
Durand MC, Porcher R, Orlikowski D, et al. Clinical and electrophysiological predictors of respiratory failure in Guillain-Barré syndrome:a prospective study[J]. Lancet Neurol, 2006, 5(12):1021-1028.
[7]
Niu JW, Liu MS, Sun Q, et al. Motor nerve conduction block predicting outcome of Guillain-Barre syndrome[J]. Front Neurol, 2018, 9:399.
[8]
Wakerley BR, Uncini A, Yuki N, et al. Guillain-Barré and Miller Fisher syndromes-new diagnostic classification[J]. Nat Rev Neurol, 2014, 10(9):537-544.
[9]
Chan YC, Punzalan-Sotelo AM, Kannan TA, et al. Electrodiagnosis of reversible conduction failure in Guillain-Barré syndrome[J]. Muscle Nerve, 2017, 56(5):919-924.
[10]
Cai F, Zhang J. Study of nerve conduction and late responses in normal Chinese infants, children, and adults[J]. J Child Neurol, 1997, 12(1):13-18.
[11]
Sekiguchi Y, Uncini A, Yuki N, et al. Antiganglioside antibodies are associated with axonal Guillain-Barré syndrome:a Japanese-Italian collaborative study[J]. J Neurol Neurosurg Psychiatry, 2012, 83(1):23-28.
[12]
American Association of Electrodiagnostic Medicine, Olney RK. Guidelines in electrodiagnostic medicine. Consensus criteria for the diagnosis of partial conduction block[J]. Muscle Nerve Suppl, 1999, 8:S225-S229.
[13]
Hughes RA, Newsom-Davis JM, Perkin GD, et al. Controlled trial prednisolone in acute polyneuropathy[J]. Lancet, 1978, 2(8093):750-753.
[14]
Ho TW, Hsieh ST, Nachamkin I, et al. Motor nerve terminal degeneration provides a potential mechanism for rapid recovery in acute motor axonal neuropathy after campylobacter infection[J]. Neurology, 1997, 48(3):717-724.
[15]
Bae JS, Yuki N, Kuwabara S, et al. Guillain-Barré syndrome in Asia[J]. J Neurol Neurosurg Psychiatry, 2014, 85(8):907-913.
[16]
Uncini A, Yuki N. Electrophysiologic and immunopathologic correlates in Guillain-Barré syndrome subtypes[J]. Expert Rev Neurother, 2009, 9(6):869-884.
[17]
Ye Y, Wang K, Deng F, et al. Electrophysiological subtypes and prognosis of Guillain-Barré syndrome in Northeastern China[J]. Muscle Nerve, 2013, 47(1):68-71.
[18]
Uncini A, Kuwabara S. The electrodiagnosis of Guillain-Barré syndrome subtypes:where do we stand?[J]. Clin Neurophysiol, 2018, 129(12):2586-2593.
