thesis
Electrodiagnostic studies in Guillain-Barre syndrome
- Publication date
- 30 November 1994
- Publisher
- The Guillain-Barre syndrome (GBS) is a monophasic (sub)acute inflammatory
demyelinating predominantly motor polyradiculo-neuropathy. Clinical criteria
have been proposed by Asbury (Asbury et aI., 1978; Asbury and Cornblath, 1990).
GBS is a selflimiting disease, however, up to 30% of the patients may need
temporary artificial ventilation; about 15% remain disabled and mortality is estimated
to be up to 5%. Therefore, GBS must be regarded as a serious disease.
Plasma exchange (PE) and more recently high dose immune globulins ([vIg) have
been proved to be succesful in shortening the duration of the disease, the duration
of artificial ventilation and to improve outcome at 6 months (GBS study group, 19-
85; van del' Meche et aI., 1992; French cooperative group, 1992). In contrast to
immune globulin therapy, plasma exchange is not always possible for haemodynamic
reasons. In addition it is generally not feasible in children, not in all hospitals
available, and is in general rather cumbersome. Therefore in the multicentre Dutch
Guillain-Barn: Study the effectiveness of immune globulins versus plasma exchange
was evaluated in 150 patients, with a main aim to demonstrate at least equal
efficacy. This study revealed therapeutic effectiveness of both therapies with a
limited but significant superiority of immune globulins over plasma exchange (van
del' Meche et aI., 1992).
[n the Dutch Guillain-Barre trial each patient was tested electrodiagnostically three
times in an early stage of the disease according to a rigid protocol. The results of
these electro diagnostic studies are the subject of this thesis.