Relevance of Brain Stem and Visual Evoked Potentials in Diagnosis of Central Demyelination in Guillain Barre Syndrome | Chapter 12 | Emerging Research in Medical Sciences Vol. 2
Aims:
Guillain Barre Syndrome (GBS) is an auto-immune mediated demyelination
polyradiculoneuropathy. Clinical features include progressive symmetrical
ascending muscle weakness of more than two limbs, areflexia with or without
sensory, autonomic and brainstem abnormalities. The purpose of this study was
to determine subclinical neurological changes of CNS with GBS & to
establish the presence of central demyelination in GBS.
Study
Design:
A prospective study to find out early Central demyelination in clinically
diagnosed patients of GBS.
Place
and Duration of Study: Department of Physiology, Pt. B.D.
Sharma Post-Graduate Institute of Medical Sciences, University of Health
Sciences, Rohtak, Haryana, India, between January 2014 and June 2015.
Methodology:
The patients were referred from the Department of Medicine to our Department
for electro-diagnostic evaluation. The study group comprised of 40 subjects (20
clinically diagnosed GBS patients and 20 healthy individuals) aged between
6-65years. Brain stem and visual evoked potentials were done in both groups
using RMS EMG EP Mark II machine. BAEP parameters included the latencies of
waves I to IV, inter-peak latencies I-III, III_IV & I-V while VEP included
latencies of P100 waves.
Results:
Statistically significant increase in absolute peak and inter-peak latency in
the GBS group as compared to the control group was noted. Prolongation of
latency of P100 wave latency in both the right and left eyes was also recorded
in the GBS group.
Conclusion:
Results of evoked potentials reflect impairment of auditory and visual pathways
probably due to focal demyelination in Schwann cell derived myelin sheaths that
cover the extramedullary portion of the auditory nerves and also due to demyelination
of optic pathways. Prolonged central conduction time in BAEPS & VEPS
suggest the subclinical auditory and optical involvement in GBS. Early
detection of the sub-clinical abnormalities is also important as timely
intervention reduces morbidity and mortality.
Author(s) Details
Professor Dr. Geetanjali
Sharma
Department of Physiology,
Pt. B.D. Sharma Post-Graduate Institute of Medical Sciences, University of
Health Sciences, Rohtak, Haryana, India.
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