Details

Autor(en) / Beteiligte

• Al-Hakem, Helle
• Doets, Alex Y
• Stino, Amro Maher
• Zivkovic, Sasha A
• Andersen, Henning
• Willison, Hugh J
• Cornblath, David R
• Gorson, Kenneth C
• Islam, Zhahirul
• Mohammad, Quazi Deen
• Sindrup, Søren Hein
• Kusunoki, Susumu
• Davidson, Amy
• Casasnovas, Carlos
• Bateman, Kathleen
• Miller, James A L
• van den Berg, Bianca
• Verboon, Christine
• Roodbol, Joyce
• Leonhard, Sonja E
• Arends, Samuel
• Luijten, Linda W G
• Benedetti, Luana
• Kuwabara, Satoshi
• Van den Bergh, Peter
• Monges, Soledad
• Marfia, Girolama A
• Shahrizaila, Nortina
• Galassi, Giuliana
• Pereon, Yann
• Bürmann, Jan
• Kuitwaard, Krista
• Kleyweg, Ruud P
• Marchesoni, Cintia
• Sedano Tous, María J
• Querol, Luis
• Martín-Aguilar, Lorena
• Wang, Yuzhong
• Nobile-Orazio, Eduardo
• Rinaldi, Simon
• Schenone, Angelo
• Pardo, Julio
• Vermeij, Frederique H
• Waheed, Waqar
• Lehmann, Helmar C
• Granit, Volkan
• Stein, Beth
• Cavaletti, Guido
• Gutiérrez-Gutiérrez, Gerardo
• Barroso, Fabio A
• Visser, Leo H
• Katzberg, Hans D
• Dardiotis, Efthimios
• Attarian, Shahram
• van der Kooi, Anneke J
• Eftimov, Filip
• Wirtz, Paul W
• Samijn, Johnny P A
• Gilhuis, H Jacobus
• Hadden, Robert D M
• Holt, James K L
• Sheikh, Kazim A
• Kolb, Noah
• Karafiath, Summer
• Vytopil, Michal
• Antonini, Giovanni
• Feasby, Thomas E
• Faber, Catharina
• Kramers, Hans
• Busby, Mark
• Roberts, Rhys C
• Silvestri, Nicholas J
• Fazio, Raffaella
• van Dijk, Gert W
• Garssen, Marcel P J
• Verschuuren, Jan
• Harbo, Thomas
• Jacobs, Bart C

Titel

CSF Findings in Relation to Clinical Characteristics, Subtype, and Disease Course in Patients With Guillain-Barré Syndrome

Ist Teil von

• Neurology, 2023-06, Vol.100 (23), p.e2386

Ort / Verlag

United States

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• To investigate CSF findings in relation to clinical and electrodiagnostic subtypes, severity, and outcome of Guillain-Barré syndrome (GBS) based on 1,500 patients in the International GBS Outcome Study. Albuminocytologic dissociation (ACD) was defined as an increased protein level (>0.45 g/L) in the absence of elevated white cell count (<50 cells/μL). We excluded 124 (8%) patients because of other diagnoses, protocol violation, or insufficient data. The CSF was examined in 1,231 patients (89%). In 846 (70%) patients, CSF examination showed ACD, which increased with time from weakness onset: ≤4 days 57%, >4 days 84%. High CSF protein levels were associated with a demyelinating subtype, proximal or global muscle weakness, and a reduced likelihood of being able to run at week 2 (odds ratio [OR] 0.42, 95% CI 0.25-0.70; = 0.001) and week 4 (OR 0.44, 95% CI 0.27-0.72; = 0.001). Patients with the Miller Fisher syndrome, distal predominant weakness, and normal or equivocal nerve conduction studies were more likely to have lower CSF protein levels. CSF cell count was <5 cells/μL in 1,005 patients (83%), 5-49 cells/μL in 200 patients (16%), and ≥50 cells/μL in 13 patients (1%). ACD is a common finding in GBS, but normal protein levels do not exclude this diagnosis. High CSF protein level is associated with an early severe disease course and a demyelinating subtype. Elevated CSF cell count, rarely ≥50 cells/μL, is compatible with GBS after a thorough exclusion of alternative diagnoses. This study provides Class IV evidence that CSF ACD (defined by the Brighton Collaboration) is common in patients with GBS.