Summary
Clinical and electrophysiological studies were carried out on 39 patients with the Guillain-Barré syndrome to evaluate which elements were of prognostic value during the acute phase. Residual clinical signs such as motor weakness and absent patellar tendon reflexes were found in 16 (52%) of those patients who had had a preceding illness. Persistence of deficit was significantly correlated to age at onset, the degree of quadriparesis and loss of deep sensation in the acute phase. Of the 10 patients who showed a reduction in motor nerve conduction velocity (MCV) in the early stage, 8 (80%) revealed significantly residual clinical symptoms at follow-up. There was a tendency for the incidence of residual signs to be more common in the patients with slowing of mixed nerve conduction velocity, and prolonged latency of H-wave and the residual latency. Nerve conduction studies, especially measurement of MCV, were of value as a reliable prognostic indicator in this syndrome.
Zusammenfassung
Klinisch-elektrophysiologische Untersuchungen wurden bei 39 Patienten mit Guillain-Barré Syndrom durchgeführt. Es ging um die Frage, welche Elemente in der akuten Phase eine prognostische Beurteilung zulassen. Bei 16 der Patienten, was 52% des Krankengutes entspricht, wurden residuelle Symptome wie motorische Schwäche, fehlende Patellarsehnenreflexe und so weiter nachgewiesen. Das Zurückbleiben von residuellen Symptomen korrelierte mit dem Alter bei Krankheitsbeginn, das Ausmaß der Tetraparese und das Ausmaß der Sensibilitätsstörungen in der akuten Phase. Acht der zehn Patienten, die eine Verminderung der motorischen Nervenleitgeschwindigkeit in einer frühen Krankheitsphase aufwiesen, zeigten später nennenswerte Restsymptome. Tendenzmäßig schienen Restsymptome häufiger bei jenen Patienten zu sein, welche eine Verlangsamung der Leitgeschwindigkeit gemischter Nerven und eine verlängerte Latenz der H-Welle sowie der Residuallatenz aufwiesen. Elektroneurographische Untersuchungen, im besonderen die Bestimmung der motorischen Leitgeschwindigkeit, erlauben zuverlässige Rückschlüsse auf die Prognose dieses Krankheitsbildes.
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Takeuchi, H., Takahashi, M., Kang, J. et al. The Guillain-Barré syndrome: clinical and electroneuromyographic studies. J Neurol 231, 6–10 (1984). https://doi.org/10.1007/BF00313644
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DOI: https://doi.org/10.1007/BF00313644