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Abstract Details

Electrophysiological factors related to poor short-term functional prognosis in Guillain-Barré syndrome
Neuromuscular and Clinical Neurophysiology (EMG)
Neuromuscular and Clinical Neurophysiology (EMG) Posters (7:00 AM-5:00 PM)
142
To analyze the characteristics of neurophysiological studies in Guillain-Barré syndrome (GBS) patients from a reference center and their poor functional prognosis relation.
Up to 30% of GBS patients show a poor functional prognosis (Hughes ≥3) despite prompt diagnosis and treatment. The classical clinical factors are: diarrhea history, older age, need for mechanical ventilation (MV) and loss of independent walk at diagnosis. Axonal variant is the most frequent in Latin America and Asia with worse presentation and prognosis.
Longitudinal, analytical, single center study from a prospective cohort (2017-2019) in Mexico. GBS was diagnosed by Ausbury criteria. Clinical and demographic characteristics were obtained. Lack of independent walk at three months defined poor prognosis. Mechanism of electrophysiological damage established by Rajabalys criteria. Distal CMAP/proximal CMAP <0.7 established conduction block. Clinical and electrophysiological risk factors for poor functional prognosis were identified with a multivariate logistic regression model.
91 patients. Mean age: 46.8 ± 18.6 years, men 72.5%, diarrhea history 35.2%, Hughes ≥3 80.2%, MRC score at admission 34.9 ± 16.9, median EGOS 5 (1-9), MV requirement 37.4%, axonal variant 42.9% and demyelinating 52.7%. Tibial and peroneal nerves presented the lowest distal CMAP amplitudes 1.5(0-16)mV and 1.5(0-8)mV, median nerve showed more conduction blocks (41.8%). 37 patients did not regain independent walk. Multivariate model: MV requirement OR 6.6 (95%-CI:1.8-23.0,p=0.003), peroneal nerve with distal CMAP <20% OR 5.4 (95%-CI: 1.5-19,p=0.009). AUC 0.88 (95%-CI:0.8-0.95,p=>0.001). Kaplan-Meier analysis showed an statistically significant difference in the recovery curves between peroneal nerve involvement groups with CMAP<20% with/without conduction block.
Severe damage to the peroneal nerve is a short-term poor functional prognosis factor independent of the axonal variant and EGOS score.
Authors/Disclosures
Anna L. Bazan, MD (Instituto Nacional de Neurologia)
PRESENTER 		Dr. Bazan has nothing to disclose.
No disclosure on file
No disclosure on file
Maria Eugenia Briseño Godinez No disclosure on file
No disclosure on file
No disclosure on file
Adib Jorge De Sarachaga, MD (Instituto Nacional De Neurologia Y Neurocirugia Manuel Velasco Suarez) Dr. Jorge De Sarachaga has nothing to disclose.
No disclosure on file
Elizabeth Leon Elizabeth Leon has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for BIOGEN AND SANOFI.
Edwin S. Vargas, MD (National Institute of Neurology, Mexico) Dr. Vargas has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Sanofi. Dr. Vargas has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for CSL Berhing.