Detection of proximal conduction blocks using a triple stimulation technique improves the early diagnosis of Guillain–Barré syndrome

• Published in: Clinical neurophysiology 2018-01, Vol.129 (1), p.127-132
• Main Authors: Sevy, Amandine, Grapperon, Aude-Marie, Salort Campana, Emmanuelle, Delmont, Emilien, Attarian, Shahram
• Format: Article
• Language: English
• Subjects: Acute polyradiculoneuropathy; Genetics; Human genetics; Life Sciences; Nerve conduction study; Proximal conduction blocks; SGB; TST
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2017.10.035

•The triple stimulation technique is useful to reveal proximal conduction blocks in Guillain–Barré syndrome (GBS).•Triple stimulation is useful for diagnosis of GBS in the early stages of the disease.•The combination of nerve conduction studies and triple simulation improves greatly diagnosis. Current diagnostic electrophysiological criteria can miss the early stages of Guillain–Barré syndrome (GBS). We evaluated the diagnostic efficiency of the triple stimulation technique (TST) in highlighting proximal conduction blocks (CBs) in patients who do not meet the electrophysiological criteria for GBS. All patients with a diagnosis of clinical GBS referred to our center between September 2014 and January 2016 were included in the study. For patients who did not fulfill the electrophysiological criteria of GBS, we performed the TST examination. Among the 44 included patients, 86% fulfilled the electrophysiological criteria of GBS during the initial nerve conduction study (NCS). The six remaining patients had proximal CBs revealed by TST examination. Therefore, a combination of a conventional NCS and the TST allowed 100% of the patients to be electrophysiologically diagnosed. TST is useful for the diagnosis of GBS in association with NCS, particularly in the early stages of the disease. TST is a useful tool for GBS diagnosis at the early stages of the disease.