Journal of Yeungnam Medical Science

Original article

Neurology
Predictive assessment with outcomes of phrenic nerve study in Guillain-Barré syndrome: a prospective study: Rajarshi Chakraborty, Rajesh Verma, Sarvesh Kumar Chaudhary, Harish Nigam, Ankit Khetan, Swati Shakya, Pushpita Barman, Aparajita Chakraborty; J Yeungnam Med Sci. 2025;42:45. Published online August 16, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.45

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Abstract PDF: Background
Guillain-Barré syndrome (GBS) is an acute acquired autoimmune inflammatory disorder of the peripheral nerves and roots. Respiratory insufficiency is an important predictor of a poor prognosis in patients with GBS. Phrenic nerve assessment is an area of interest in GBS with respiratory failure. We aimed to analyze the characteristics of the phrenic nerve conduction study (NCS) in GBS and assess its value in predicting respiratory failure requiring ventilatory support, along with outcome assessment at 6 months as per the Hughes score.
Methods
A total of 135 patients with GBS admitted to our hospital over 3 years were thoroughly evaluated by clinical examination, blood laboratory tests, and phrenic NCS.
Results
Phrenic NCS abnormality was observed in 48 patients (35.6%) with statistically significant increases in phrenic sum compound muscle action potential (CMAP) latency (18.91±7.82 ms) and sum CMAP duration (44.65±6.84 ms), along with reduced sum CMAP amplitude (0.3246±0.132 mV) and sum CMAP area (3.56±2.62 mV·ms) occurring in those requiring ventilatory assistance. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of the phrenic NCS for predicting respiratory failure in patients with GBS were 90.7%, 90.2%, 81.3%, 95.4%, 9.27, and 0.10, respectively. The results showed a statistically significant association between abnormal initial phrenic NCS scores and outcomes at 6 months.
Conclusion
Phrenic NCS can predict respiratory failure requiring ventilator assistance in patients with GBS. Phrenic NCS can be incorporated into routine NCS protocols to predict impending respiratory failure in patients with GBS.

Original Article

Neurology
Clinical and Electrophysiological Study on Guillain-Barre Syndrome.: Sung Hwan Yun, Jung Sang Hah, Sung Gyun Joo, Yong Kook Cho, Jung Hyun Kim, Ji Yeun Chung; Yeungnam Univ J Med. 2005;22(1):52-61. Published online June 30, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.1.52

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BACKGROUND
Guillain-Barre syndrome is defined as a recognizable clinical entity that is characterized by rapidly evolving symmetric limb weakness, the loss of tendon reflexes, absent or mild sensory signs, and variable autonomic dysfunctions. This study evaluated the clinical and electrophysiological findings retrospectively. MATERIALS AND METHODS: Forty-five patients with Guillain-Barre syndrome, who were admitted to the Yeungnam University Hospital for six years from Jan. 1994 to Dec. 1999 were investigated. The correlation between the clinical manifestation and the electrophysiological study was evaluated. RESULTS: The male to female ratio was 1.8: 1 and there was a peak seasonal incidence in the winter. A preceding illness was noted in 66.7% of cases, and an upper respiratory tract infection was the most common one. The most common clinical manifestations were a loss of tendon reflex and ascending muscle weakness and paralysis. The cerebrospinal fluid examinations revealed, albuminocytologic dissociation in 33 cases (73.3%). Intravenous immunoglobulin therapy was performed in 29 cases (64.4%). The sequential electrophysiological abnormalities were most marked at 2 to 4 weeks after onset. At that time the most significant change was a decrease in the compound muscle action potential amplitude. These 45 patients with Guillain-Barre syndrome were subclassified using the clinical and electrophysiological data. CONCLUSION: The result in this study, concured with other research on the clinical and electrophysiological data of Guillain-Barre syndrome. However, an extensive and dynamic investigation is necessary to determine the reason for the peak seasonal incidence in winter.

Citations

Citations to this article as recorded by

A Case of Combined Korean Medicine Treatment for Recurrent Limb Weakness after Guillain-Barré Syndrome Improvement: Case Report
Song-Mi Park, Sung-Woo Cho
Journal of Korean Medicine Rehabilitation.2019; 29(4): 135. CrossRef

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