CHANGING PATTERNS OF ELECTROPHYSIOLOGY IN GUILLAIN BARRE SYNDROME, MAKING IT A DYNAMIC PHENOMENON

Background: Guillain-Barré Syndrome (GBS) is a rapidly developing autoimmune disorder that affects the peripheral nervous system. Electrophysiological studies play a crucial role in diagnosing this condition. While many previous studies argue against repeated electrophysiological testing in GBS patients, attributing observed changes to the natural progression of the disease, others believe that serial electrophysiology is essential for accurate subtyping and prognostication of the condition. Aims:To study the changes in the subtypes in GuillainBarre syndrome from admission to one month after discharge. Methods: This prospective study analysed the electrophysiological changes in Guillain- Barré Syndrome patients at admission and at one month. Motor (Median, Ulnar, Tibial, Peroneal) and sensory (Median, Ulnar, Sural) nerves were tested, identifying and comparing subtypes at both time points. Results: Electrophysiological testing in 64 patients showed 19 (29.7%) with AIDP, 19 (29.7%) with an inexcitable subtype, 9 (14.1%) with AMAN, 14 (21.8%) with normal results, and 3 (4.7%) with AMSAN. Out of 64 , 8 patients succumbed and the rest 56 were studied with repeat NCS at one month which showed 19(40%) AIDP cases , 11(19.6%) AMAN cases, 6 (10.7%) AMSAN , and 20 (35.7%) inexcitable . The most signicant changes occurred in patients with normal NCS at admission. The shift in electrophysiological subtypes over the month was statistically signicant (p = 0.001). Conclusion: This study highlights the dynamic nature of electrophysiological changes in Guillain-Barré Syndrome, emphasizing the need for repeat nerve conduction studies to accurately diagnose the subtypes over time which further helps in better prognostication of the patients.