Journal of Neurology

, Volume 253, Issue 7, pp 851–856 | Cite as

Nerve conduction studies in relation to residual fatigue in Guillain-Barré syndrome

  • Marcel P. J. Garssen
  • P. A. van Doorn
  • G. H. Visser


Many Guillain-Barré syndrome (GBS) and Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) patients recover well, but suffer from excessive fatigue, which may persist for years and reduce the quality of life considerably. In order to determine whether residual subclinical peripheral nerve dysfunction is a possible underlying mechanism of fatigue, we performed standardized nerve conduction (NC) studies in 16 fatigued patients, mean 6.5 years after diagnosis. Thirteen were relatively well recovered from GBS and 3 had stable CIDP. In contrast to CIDP, most NC values in GBS patients were remarkably restored and within normal values.No correlations were found between the electrophysiological findings and the fatigue scores,muscle strength, or functional scores. This study demonstrates that fatigue in GBS is not explained by residual nerve dysfunction, using conventional NC measurements.

Key words

Guillain-Barré syndrome chronic inflammatory demyelinating polyneuropathy fatigue nerve conduction studies long-term outcome 


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  1. 1.
    Alam TA, Chaudhry V, Cornblath DR (1998) Electrophysiological studies in the Guillain-Barré syndrome: distinguishing subtypes by published criteria. Muscle Nerve 21:1275–1279PubMedCrossRefGoogle Scholar
  2. 2.
    Atanasova D, Ishpekova B, Muradyan N, Novachkova S, Daskalov M (2004) Conduction block – the diagnostic value in the early stage of Guillain- Barré syndrome. Electromyogr Clin Neurophysiol 44:361–364PubMedGoogle Scholar
  3. 3.
    Brown WF, Feasby TE (1984) Conduction block and denervation in Guillain- Barré polyneuropathy. Brain 107:219–239PubMedGoogle Scholar
  4. 4.
    Buschbacher RM (2000) Manual of NC Studies, Demos Medical Publishing, Inc. New York Google Scholar
  5. 5.
    De la Cour CD, Andersen H, Stalberg E, Fuglsang-Frederiksen A, Jakobsen J (2005) Electrophysiological signs of permanent axonal loss in a follow-up study of patients with Guillain-Barré syndrome. Muscle Nerve 31:70–77CrossRefGoogle Scholar
  6. 6.
    Emery AE (1997) Criteria for Neuromuscular Disorders, Royal Society of Medicine Press Limited, LondonGoogle Scholar
  7. 7.
    EuroQol Group (1990) A new facility for the measurement of health-related quality of life. Health Policy 16: 199–208CrossRefGoogle Scholar
  8. 8.
    Garssen MP, Bussmann JB, Schmitz PI, Zandbergen A, Welter TG, Merkies IS, Stam HJ, van Doorn PA (2004) Physical training and fatigue, fitness, and quality of life in Guillain-Barré syndrome and CIDP. Neurology 63:2393–2395PubMedGoogle Scholar
  9. 9.
    Hahn AF (1998) Guillain-Barré syndrome. Lancet 352:635–641PubMedCrossRefGoogle Scholar
  10. 10.
    Hausmanowa-Petrusewicz I, Emeryk B, Rowinska-Marcinska K, Jedrzejowska H (1979) Nerve conduction in the Guillain-Barré-Strohl syndrome. J Neurol 220:169–184PubMedCrossRefGoogle Scholar
  11. 11.
    Jablecki CK, Andary MT, So YT, Wilkins DE, Williams FH (1993) Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. AAEM Quality Assurance Committee. Muscle Nerve 16:1392–1414PubMedCrossRefGoogle Scholar
  12. 12.
    Kleyweg RP, van der Meché FG, Schmitz PI (1991) Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain-Barré syndrome. Muscle Nerve 14:1103–1109PubMedCrossRefGoogle Scholar
  13. 13.
    Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD (1989) The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46:1121–1123PubMedGoogle Scholar
  14. 14.
    Kuwabara S, Ogawara K, Mizobuchi K, Mori M, Hattori T (2001) Mechanisms of early and late recovery in acute motor axonal neuropathy. Muscle Nerve 24:288–291PubMedCrossRefGoogle Scholar
  15. 15.
    Martinez-Figueroa A, Hansen S, Ballantyne JP (1977) A quantitative electrophysiological study of acute idiopathic polyneuritis. J Neurol Neurosurg Psychiatry 40:156–161PubMedCrossRefGoogle Scholar
  16. 16.
    McLeod JG, Walsh JC, Prineas JW, Pollard JD (1976) Acute idiopathic polyneuritis. A clinical and electrophysiological follow-up study. J Neurol Sci 27:145–162PubMedCrossRefGoogle Scholar
  17. 17.
    Merkies IS, Schmitz PI, Samijn JP, van der Meché FG, van Doorn PA (1999) Fatigue in immune-mediated polyneuropathies. European Inflammatory Neuropathy Cause and Treatment (INCAT) Group. Neurology 53:1648–1654PubMedGoogle Scholar
  18. 18.
    Merkies IS, Schmitz PI, van der Meché FG, van Doorn PA (2003) Comparison between impairment and disability scales in immune-mediated polyneuropathies. Muscle Nerve 28:93–100PubMedCrossRefGoogle Scholar
  19. 19.
    Pleasure DE, Lovelace RE, Duvoisin RC (1968) The prognosis of acute polyradiculoneuritis. Neurology 18:1143–1148PubMedGoogle Scholar
  20. 20.
    Ruijten MW, Salle HJ, Kingma R (1993) Comparison of two techniques to measure the motor nerve conduction velocity distribution. Electroencephalogr Clin Neurophysiol 89:375–381PubMedCrossRefGoogle Scholar
  21. 21.
    Schillings ML, Hoefsloot W, Stegeman DF, Zwarts MJ (2003) Relative contributions of central and peripheral factors to fatigue during a maximal sustained effort. Eur J Appl Physiol 90:562–568PubMedCrossRefGoogle Scholar
  22. 22.
    Van der Meché FG, Meulstee J, Vermeulen M, Kievit A (1988) Patterns of conduction failure in the Guillain- Barré syndrome. Brain 111:405–416PubMedGoogle Scholar
  23. 23.
    Van der Meché FG, van Doorn PA, Meulstee J, Jennekens FG (2001) Diagnostic and classification criteria for the Guillain-Barré syndrome. Eur Neurol 45:133–139PubMedCrossRefGoogle Scholar

Copyright information

© Steinkopff-Verlag 2006

Authors and Affiliations

  • Marcel P. J. Garssen
    • 1
  • P. A. van Doorn
    • 1
  • G. H. Visser
    • 2
  1. 1.Department of NeurologyErasmus Medical Center RotterdamDR RotterdamThe Netherlands
  2. 2.Department of Clinical NeurophysiologyErasmus Medical Center RotterdamRotterdamThe Netherlands

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