Volume 10

Number 01 January 2020
Reduced amplitude in Peroneal Nerve in Nerve Conduction Study as a diagnostic tool in clinically suspected Guillain Barre Syndrome

DOI: NO DOI Assigned

Rahat Amin Chowdhury1 , Md Nazrul Islam2 , Md Matiur Rahman3 , Iftikher Alam4

ct Background: Guillain Barre syndrome (GBS) is an acute polyradiculoneuropathy with a variable presentation affecting all age groups. The diagnosis of GBS is based on clinical features, supported by features of electrophysiologic study, Mostly by Nerve Conduction study (NCS). Aim of the study was to evaluate Peroneal Motor Nerve involvement in NCS as a diagnostic aid to confirm GBS. Patients and methods: Sixty three patients fulfilling Brighton diagnostic criteria for GBS were enrolled in this study. Patients Referred from different Institutes to Department of Neurophysiology of Mount Adora Hospital for NCS with clinical diagnosis of GBS were included. Pre-existing neuropathy, diabetes, alcoholism, myopathy, motor neuron disorders, peripheral vascular disorders excluded. NCS was performed with Cadwell EMG machine. The test was performed on 7th day of onset of disease symptoms. Results: Three categories of GBS were identified: Acute Inflammatory Demyelinating Polyneuropathy (AIDP), Acute Motor Axonal Polyneuropathy (AMAN), Acute Motor Sensory Axonal Polyneuropathy (AMSAN). There were 39 male, 24 female patients. Maximum patient (19) admitted on 3rd day, and only one patient came on 6th day. Maximum patients were AMAN (39) followed by AMSAN (21) and AIDP (3). Notifiable change observed in Peroneal motor nerve, both Fibular head and Popliteal parts. Mean amplitude were reduced significantly (p <0.0001) from the normal values where latency were statistically within normal level. In AMAN, common peroneal nerve involvement only found in 18 cases, while Peroneal with other nerve involvement occurred in 21 cases. On the other hand, in AMSAN, Common Peroneal and Sural nerve involvement only found in 12 cases, and multiple nerves involvement observed in 9 case. Odd ratio for the Peroneal nerve involvement in AMAN only was 1.5556 and in AMSAN was 1.3333. Conclusion Peroneal Neuropathy may be the only NCS abnormality aiding towards diagnosing GBS.