المؤلفون: Aude-Marie Grapperon, Guillaume Nicolas, Peter Van den Bergh, John L. Woodard, Jean-Marc Raymackers, Claure Michel, F Piéret, Yusuf A. Rajabally, Shahram Attarian, Emilien Delmont, P. Jacquerye, Marion Brisset, Céline Redant, Vinciane Van Parijs, Julien Cassereau, Donatienne Verougstraete

المصدر: Muscle & Nerve. 58:23-28

مصطلحات موضوعية: 0301 basic medicine, Pathology, medicine.medical_specialty, Disease onset, Guillain-Barre syndrome, Physiology, business.industry, Polyradiculoneuropathy, medicine.disease, Acute motor axonal neuropathy, Pathophysiology, 3. Good health, 03 medical and health sciences, Cellular and Molecular Neuroscience, 030104 developmental biology, 0302 clinical medicine, Muscle nerve, Electrodiagnostic testing, Physiology (medical), Medicine, Neurology (clinical), business, 030217 neurology & neurosurgery

الوصف: Introduction There is uncertainty as to whether the Guillain-Barre syndrome (GBS) subtypes, acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy (AMAN), can be diagnosed electrophysiologically. Methods We prospectively included 58 GBS patients. Electrodiagnostic testing (EDX) was performed at means of 5 and 33 days after disease onset. Two traditional and one recent criteria sets were used to classify studies as demyelinating or axonal. Results were correlated with anti-ganglioside antibodies and reversible conduction failure (RCF). Results No classification shifts were observed, but more patients were classified as axonal with recent criteria. RCF and anti-ganglioside antibodies were present in both subtypes, more frequently in the axonal subtype. Discussion Serial EDX has no effect on GBS subtype proportions. The absence of exclusive correlation with RCF and anti-ganglioside antibodies may challenge the concept of demyelinating and axonal GBS subtypes based upon electrophysiological criteria. Frequent RCF indicates that nodal/paranodal alterations may represent the main pathophysiology. Muscle Nerve, 2018.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::32de6d18d33b753e63b6973bc50042b4Test
https://doi.org/10.1002/mus.26056Test

المؤلفون: Yusuf A. Rajabally, Peter Van den Bergh

المصدر: Presse medicale (Paris, France : 1983). 42(6 Pt 2)

مصطلحات موضوعية: medicine.medical_specialty, Nerve biopsy, biology, medicine.diagnostic_test, business.industry, Prevalence, Disease Management, Peripheral Nervous System Diseases, Polyradiculoneuropathy, General Medicine, Disease, Gold standard (test), medicine.disease, Gastroenterology, Pathophysiology, Pathogenesis, Treatment Outcome, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating, Internal medicine, biology.protein, Medicine, Humans, Immunotherapy, Antibody, business

الوصف: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is the most common autoimmune neuropathy. The diagnosis depends on the clinical presentation with a progressive or relapsing course over at least 2 months and electrophysiological evidence of primary demyelination. Whereas typical CIDP is quite easily recognizable because virtually no other neuropathies present with both distal and proximal motor and sensory deficit, atypical CIDP, focal and multifocal variants in particular, may represent a difficult diagnostic challenge. CIDP very likely is an underdiagnosed condition as suggested also by a positive correlation between prevalence rates and sensitivity of electrophysiological criteria. Since no 'gold standard' diagnostic marker exists, electrophysiological criteria have been optimized to be at the same time as sensitive and as specific as possible. Additional supportive laboratory features, such as increased spinal fluid protein, MRI abnormalities of nerve segments, and in selected cases nerve biopsy lead to the correct diagnosis in the large majority of the cases. Objective clinical improvement following immune therapy is also a useful parameter to confirm the diagnosis. The pathogenesis and pathophysiology of CIDP remain poorly understood, but the available evidence for an inflammatory origin is quite convincing. Steroids, intravenous immunoglobulin (IVIG), and plasma exchange (PE) have been proven to be effective treatments. IVIG usually leads to rapid improvement, which is useful in severely disabled patients. Repeat treatment over regular time intervals for many years is often necessary. The effect of steroids is slower and the side-effect profile may be problematic, but they may induce disease remission more frequently than IVIG. An important and as of yet uncompletely resolved issue is the evaluation of long-term outcome to determine whether the disease is still active and responsive to treatment.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::24adb898fff4325bd3aa1b3c2de19723Test
https://pubmed.ncbi.nlm.nih.gov/23623582Test