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Document Type

Original Article

Abstract

The objective of our study was to determine the distribution of different electrophysiological variants of GBS and its relationship with albuminocytological dissociation (ACD). The rationale of the study was to determine whether presence or absence of albuminocytological dissociation has any association with NCS findings and whether can be relied upon as an indirect predictor of axonal variant which warrants poor patient out comes versus demyelinating. Materials and Methods: A consecutive series of 76 patients who presented at PIMS over a 12 month period with GBS were included. Nerve Conduction studies (NCS) and Electromyographic (EMG) findings with CSF characterization for albuminocytological dissociation were recorded. P value < 0.05 was taken significant. Results: NCS revealed AIDP as the most common variant (44; 57.8%) followed by AMAN (19; 25%) and AMSAN (7; 9.2%).For 5(6.5%) patients with normal NCS, EMG revealed early neuropathic changes in 4 (80% of normal NCS; 5.2% of total) (suggesting axonal degeneration). Total axonal degenerative type accounted for (AMAN + AMSAN + axonal neuropathy on EMG=30) 39.4% while demyelinating (AIDP + prolonged/absent F-wave=45) 59.2%. ACD was found in 60 (78.9%) patients.There was no signification association between ACD and NCS variants (p>0.05). Conclusion: AIDP is the most prevalent (58%) GBS variant in our population, at least in the vicinity of Islamabad. There is high prevalence of axonal variants (≈40% of total) as compared to Western countries. There is no correlation between ACD and NCS variants. ACD cannot be used as an independent predictor of NCS variant. Presence or absence of ACD has no definite predilection for axonal variant which itself warrants poor patient outcomes versus demyelinating type.

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