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CSF Findings in Relation to Clinical Characteristics, Subtype, and Disease Course in Patients With Guillain-Barré Syndrome

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dc.contributor.author Al-Hakem, Helle
dc.contributor.author Doets, Alex Y.
dc.contributor.author Stino, Amro Maher
dc.contributor.author Zivkovic, Sasha A.
dc.contributor.author Andersen, Henning
dc.contributor.author Willison, Hugh J.
dc.contributor.author Cornblath, David R.
dc.contributor.author Gorson, Kenneth C.
dc.contributor.author Islam, Zhahirul
dc.contributor.author Mohammad, Quazi Deen
dc.contributor.author Sindrup, Soren H.
dc.contributor.author Kusunoki, Susumu
dc.contributor.author Davidson, Amy
dc.contributor.author Casasnovas, Carlos
dc.contributor.author Bateman, Kathleen J.
dc.contributor.author Miller, James A. L.
dc.contributor.author Van den Berg, Bianca
dc.contributor.author Verboon, Christine
dc.contributor.author Roodbol, Joyce
dc.contributor.author Barroso, Fabio Adrián
dc.date.accessioned 2023-12-15T16:49:24Z
dc.date.available 2023-12-15T16:49:24Z
dc.date.issued 2023-04-19
dc.identifier.citation Al-Hakem H, Doets AY, Stino AM, Zivkovic SA, Andersen H, Willison HJ, Cornblath DR, Gorson KC, Islam Z, Mohammad QD, Sindrup SH, Kusunoki S, Davidson A, Casasnovas C, Bateman KJ, Miller JAL, van den Berg B, Verboon C, Roodbol J, Leonhard SE, Arends S, Luijten LWG, Benedetti L, Kuwabara S, Van den Bergh P, Monges S, Marfia GA, Shahrizaila N, Galassi G, Pereon Y, Bürmann J, Kuitwaard K, Kleyweg RP, Marchesoni C, Sedano Tous MJ, Querol L, Martín-Aguilar L, Wang Y, Nobile-Orazio E, Rinaldi S, Schenone A, Pardo J, Vermeij FH, Waheed W, Lehmann HC, Granit V, Stein B, Cavaletti G, Gutiérrez-Gutiérrez G, Barroso FA, Visser LH, Katzberg HD, Dardiotis E, Attarian S, van der Kooi AJ, Eftimov F, Wirtz PW, Samijn JPA, Gilhuis HJ, Hadden RDM, Holt JKL, Sheikh KA, Kolb N, Karafiath S, Vytopil M, Antonini G, Feasby TE, Faber C, Kramers H, Busby M, Roberts RC, Silvestri NJ, Fazio R, van Dijk GW, Garssen MPJ, Verschuuren J, Harbo T, Jacobs BC; IGOS Consortium. CSF Findings in Relation to Clinical Characteristics, Subtype, and Disease Course in Patients With Guillain-Barré Syndrome. Neurology. 2023 Jun 6;100(23):e2386-e2397. doi: 10.1212/WNL.0000000000207282. es_ES
dc.identifier.uri https://doi.org/10.1212/WNL.0000000000207282
dc.identifier.uri https://repositorio.fleni.org.ar/xmlui/handle/123456789/911
dc.description.abstract Background and Objectives To investigate CSF findings in relation to clinical and electrodiagnostic subtypes, severity, and outcome of Guillain-Barré syndrome (GBS) based on 1,500 patients in the International GBS Outcome Study. Methods Albuminocytologic dissociation (ACD) was defined as an increased protein level (>0.45 g/L) in the absence of elevated white cell count (<50 cells/μL). We excluded 124 (8%) patients because of other diagnoses, protocol violation, or insufficient data. The CSF was examined in 1,231 patients (89%). Results In 846 (70%) patients, CSF examination showed ACD, which increased with time from weakness onset: ≤4 days 57%, >4 days 84%. High CSF protein levels were associated with a demyelinating subtype, proximal or global muscle weakness, and a reduced likelihood of being able to run at week 2 (odds ratio [OR] 0.42, 95% CI 0.25–0.70; p = 0.001) and week 4 (OR 0.44, 95% CI 0.27–0.72; p = 0.001). Patients with the Miller Fisher syndrome, distal predominant weakness, and normal or equivocal nerve conduction studies were more likely to have lower CSF protein levels. CSF cell count was <5 cells/μL in 1,005 patients (83%), 5–49 cells/μL in 200 patients (16%), and ≥50 cells/μL in 13 patients (1%). Discussion ACD is a common finding in GBS, but normal protein levels do not exclude this diagnosis. High CSF protein level is associated with an early severe disease course and a demyelinating subtype. Elevated CSF cell count, rarely ≥50 cells/μL, is compatible with GBS after a thorough exclusion of alternative diagnoses. Classification of Evidence This study provides Class IV evidence that CSF ACD (defined by the Brighton Collaboration) is common in patients with GBS. es_ES
dc.language.iso eng es_ES
dc.publisher Lippincott Williams & Wilkins es_ES
dc.subject Guillain-Barre Syndrome es_ES
dc.subject Síndrome de Guillain-Barré es_ES
dc.subject Miller Fisher Syndrome es_ES
dc.subject Síndrome de Miller Fisher es_ES
dc.subject Cerebrospinal Fluid es_ES
dc.subject Líquido Cefalorraquídeo es_ES
dc.title CSF Findings in Relation to Clinical Characteristics, Subtype, and Disease Course in Patients With Guillain-Barré Syndrome es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.description.fil Fil: Barroso, Fabio Adrián. Fleni. Departamento de Neurología. Servicio de Neurofisiología; Argentina.
dc.relation.ispartofVOLUME 100
dc.relation.ispartofNUMBER 23
dc.relation.ispartofPAGINATION e2386-e2397
dc.relation.ispartofCOUNTRY Estados Unidos
dc.relation.ispartofCITY Hagerstown
dc.relation.ispartofTITLE Neurology
dc.relation.ispartofISSN 1526-632X
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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