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Diagnosis of Guillain-Barré syndrome and validation of the Brighton criteria in Malaysia.
Journal of the Peripheral Nervous System ( IF 3.9 ) Pub Date : 2020-06-29 , DOI: 10.1111/jns.12398
Cheng-Yin Tan 1 , Siti Nur Omaira Razali 1 , Khean-Jin Goh 1 , Nortina Shahrizaila 1
Affiliation  

We aimed to evaluate the key diagnostic features of Guillain‐Barré 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.

中文翻译:

吉兰-巴雷综合征的诊断和马来西亚布莱顿标准的验证。

我们旨在评估马来西亚患者吉兰-巴雷综合征 (GBS) 的关键诊断特征并验证布莱顿标准。这是一项对 2010 年至 2019 年间出现 GBS 和 Miller Fisher 综合征 (MFS) 患者的回顾性研究。评估了 Brighton 标准的敏感性。共纳入 128 名患者(95 GBS,33 MFS)。在 GBS 队列中,92 (97%) 名患者出现对称性肢体无力。90 (95%) 名患者的反射减弱或消失。几乎所有患者 (94, 99%) 都遵循单相病程,其中 5 (5%) 名患者经历了与治疗相关的波动。在 62/84 (73%) 患者中观察到脑脊液 (CSF) 蛋白细胞分离。神经传导研究 (NCS) 显示 90/94 (96%) 患者出现神经病变。在具有完整数据集的 GBS 患者中 (84),56 名 (67%) 患者达到 Brighton 标准的 1 级,21 名 (25%) 达到 2 级,3 名 (4%) 达到 3 级,4 名 (5%) 达到 4 级。 在 MFS 中,存在临床三联征在 25 (76%) 名患者中。所有患者均为单相病程。10/25 (40%) 患者出现脑脊液蛋白细胞分离。25/33 (76%) 患者的 NCS 正常或显示感觉神经病变。在数据集完整的 MFS 患者 (25) 中,5 (20%) 名患者达到了 Brighton 标准的 1 级,14 (56%) 名达到了 2 级,2 (8%) 名达到了 3 级,4 名 (16%) 达到了水平4. 包含抗神经节苷脂抗体提高了两个队列中布莱顿标准的敏感性。在马来西亚队列中,Brighton 标准在达到 GBS 的最高诊断确定性方面表现出中等至高度的敏感性,但在 MFS 中的敏感性较低。
更新日期:2020-06-29
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