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Clin Neurophysiol. 2012 Jun;123(6):1234-41. doi: 10.1016/j.clinph.2011.10.005. Epub 2011 Nov 4.

A-waves in Guillain-Barré syndrome: correlation with electrophysiological subtypes and antiganglioside antibodies.

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1
Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan.

Abstract

OBJECTIVE:

To investigate the relationship of A-waves with conventional electrophysiological subtypes of Guillain-Barré syndrome (GBS), as well as with anti-ganglioside antibodies.

METHODS:

The subjects consisted of 30GBS patients who were classified into acute inflammatory demyelinating polyradiculoneuropathy (AIDP), acute motor axonal neuropathy, and unclassified based on the results of nerve conduction studies. "Abundant A-waves" were defined for the upper-limb nerves (median and ulnar nerves) using receiver-operator characteristic curves. The presence or absence of IgG anti-ganglioside antibodies was also noted.

RESULTS:

Abundant A-waves at weeks 3-6 from onset were observed in 64% of the 14 AIDP patients and 0% of 16 non-AIDP patients, and in 60% of 15 antibody-negative patients and 0% of 15 antibody-positive patients. In the earlier period, this relationship was less clear. The correlation between the conventional electrophysiological subtypes and antibodies was present, but was much weaker.

CONCLUSIONS:

Abundant A-waves in GBS after the acute phase were strongly associated with demyelination that was not mediated by antiganglioside antibodies, possibly through the mechanism of proximal re-excitation induced by electrical inhomogeneities due to segmental demyelination.

SIGNIFICANCE:

Abundant A-waves are promising as a novel reliable marker of demyelination.

PMID:
22055840
DOI:
10.1016/j.clinph.2011.10.005
[Indexed for MEDLINE]

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