Proprioceptive and Sympathetic Nerve Fibers Affection in Guillain-Barre Syndrome
نویسنده
چکیده
Background: autonomic affection is well known in Guillain Barre’. However, exact affection of proprioceptive fibers and sympathetic fibers are still not documented. Aim: to investigate the magnitude of proprioceptive and sympathetic fibers involvement in patients with Guillan Barre’ syndrome (GBS) electrophysiologically. Design: cross sectional study. Setting: outpatient setting. Population: twenty patients diagnosed as GBS and 20 healthy matched controls were included. Methods: The proprioceptive Ia afferent fibers conduction velocity using electrically induced reflex activity (R1) and sympathetic skin response (SSR) were studied in upper and lower limbs of 20 patients fulfilling the criteria of GBS and 20 healthy volunteers. Results: Median nerve proprioceptive Ia afferent fibers CV showed significant slowing in patients: 29.5±17.4 m/s compared to control subjects: 68.1±16.8m/s. Posterior tibial nerve proprioceptive Ia afferent fibers CV showed significant slowing in patients: 30±19.1m/s compared to control subjects: 57.4±16.1m/s. Nine patients (45%) showed absent SSR in the hand, while 12 patients (60%) showed absent SSR in the foot. Hand SSR showed significant delay: 1.26±0.3 sec and decrease amplitude: 54.2±43.8μv in patients compared to control:1.08±0.2 sec, 99.4±64.4 μv. Foot SSR showed significant delay:1.8 μv0.6 sec and decrease of amplitude: 16.5 ±6.2 μv in patients compared to control: 1.6 ±0.2 sec, 36.5 ±23.8 μv. Conclusions: The study of electrically induced reflex activity revealed significant involvement of proprioceptive Ia afferent fibers in patients with GBS and was correlated significantly with the severity of neuropathy. SSR study showed significant involvement of sympathetic fibers in patients with GBS but not correlated with the severity of neuropathy.
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