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July 1991

Electrodiagnosis Corroborates the Neuropathology in the Guillain-Barré Syndrome

Author Affiliations

Department of Neurology, Suite 620 4320 Wornall Rd Kansas City, MO 64111

Arch Neurol. 1991;48(7):678. doi:10.1001/archneur.1991.00530190020007

To the Editor.  —Ropper et al1 performed electrodiagnostic tests on 113 patients with acute Guillain-Barré syndrome (GBS), 103 tests within 3 weeks of onset. Criteria for the clinical diagnosis of GBS included progressive limb weakness over 3 weeks or less, distal limb paresthesias, and absent tendon reflexes (cerebrospinal fluid pleocytosis; conditions and accompanying illness known to be associated with polyradiculoneuropathy apparently were not excluded). They found three main patterns of electrophysiological abnormality as follows: (1) isolated proximal conduction block; (2) proximal block coupled with distal lesion or distal block; and (3) generalized slowing. Ropper et al1 remark that correlative pathology studies have not been performed, but their electrophysiologic studies correlate with the neuropathologic evolution of GBS.There is general agreement that the most consistent histologic findings occur in the proximal portion of the peripheral nervous system where the nerve roots fuse.2 According to Haymaker and Kernohan,3