S47. Sensory Guillain Barré syndrome. (May 2018)

• Record Type: Journal Article
• Authors: Cejas, Luciana Leon; Pantiu, Fatima; Chaves, Marcelo; Mackinnon, Agustin; Marchesoni, Cintia; Pardal, Ana; Calandra, Cristian; Rodriguez, Alejandro; Reisin, Ricardo
• Is Part Of: Clinical neurophysiology. Volume 129(2018)Supplement 1
• Page Start: e159
• Publication Date: 2018-05
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2018.04.407
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : Introduction: The classic Guillain Barré syndrome (GBS) is characterized by motor weakness, hyporreflexia, but limited sensory deficits. Sensory variants involving either small or large fibers or both are unusual and represent a diagnostic challenge. Methods: We described 6 patients presenting with the sensory variant of GBS and retrospectively analyzed the clinical and electrophysiological findings of patients fulfilling the criteria for Sensory GBS according to Oh et al. criteria. Results: Six patients were identified (mean age 38 years: range 15–54 years). Four had a previous infection. They all consulted due to distal painful paresthesias and allodynia. On examination the 6 patients presented normal strength and normal cranial nerves through the course of the disease with reduced knee and ankle reflexes in 3 patients. Distal hyperesthesia to pinprick was identified in 3 and one of them additionally had hyperhidrosis and constipation. Two additional patients presented hypoesthesia to pinprick and temperature. One patient had distal proprioceptive sensory loss with sensory ataxia. CSF albumin cytological dissociation was present in 3 patients. Nerve conduction studies (NCS) identified a sensory motor demyelinating neuropathy in 2 patients. Among the 4 with normal NCS, 2 had abnormal cold and warm threshold in their QST evaluation. All patients received symptomatic treatment for the neuropathic pain and only two IvIg therapies. Longstanding pain, fatigue or both were persistent findings in 5 patients after a mean follow up of 6 months. Conclusion: The sensory variant of GBS is both an infrequent presentation and a diagnostic challenge. Longstanding pain and fatigue are common persisting findings.