Diagnosis of Guillain-Barresyndrome and validation of the brighton criteria in Malaysia

Tan, Cheng-Yin and Razali, Siti Nur Omaira and Goh, Khean-Jin and Shahrizaila, Nortina (2020) Diagnosis of Guillain-Barresyndrome and validation of the brighton criteria in Malaysia. Journal of the Peripheral Nervous System, 25 (3). pp. 256-264. ISSN 1085-9489, DOI https://doi.org/10.1111/jns.12398.

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Abstract

We aimed to evaluate the key diagnostic features of Guillain-Barre syndrome (GBS) in Malaysian patients and validate the Brighton criteria. This was a retrospective study of patients presenting with GBS and Miller Fisher syndrome (MFS) between 2010 and 2019. The sensitivity of the Brighton criteria was evaluated. A total of 128 patients (95 GBS, 33 MFS) were included. In the GBS cohort, 92 (97%) patients presented with symmetrical limb weakness. Reflexes were depressed or absent in 90 (95%) patients. Almost all patients (94, 99%) followed a monophasic disease course, with 5 (5%) patients experiencing treatment-related fluctuations. Cerebrospinal fluid (CSF) albuminocytological dissociation was seen in 62/84 (73%) patients. Nerve conduction study (NCS) revealed neuropathy in 90/94 (96%) patients. In GBS patients with complete dataset (84), 56 (67%) patients reached level 1 of the Brighton criteria, 21 (25%) reached level 2, 3 (4%) reached level 3, and 4 (5%) reached level 4. In MFS, the clinical triad was present in 25 (76%) patients. All patients had a monophasic course. CSF albuminocytological dissociation was present in 10/25 (40%) patients. NCS was normal or showed sensory neuropathy in 25/33 (76%) patients. In MFS patients with complete dataset (25), 5 (20%) patients reached level 1 of the Brighton criteria, 14 (56%) reached level 2, 2 (8%) reached level 3, and 4 (16%) reached level 4. Inclusion of antiganglioside antibodies improved the sensitivity of the Brighton criteria in both cohorts. In the Malaysian cohort, the Brighton criteria showed a moderate to high sensitivity in reaching the highest diagnostic certainty of GBS, but the sensitivity was lower in MFS.

Item Type: Article
Funders: None
Uncontrolled Keywords: Acute inflammatory demyelinating polyneuropathy; Acute motor axonal neuropathy; Brighton criteria; Guillain-Barre syndrome; Miller Fisher syndrome
Subjects: R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions: Faculty of Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 27 Nov 2024 04:04
Last Modified: 28 Nov 2024 04:03
URI: http://eprints.um.edu.my/id/eprint/36601

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