AAEM case report 4: Guillain–Barré syndrome

A 57-year-old woman developed rapidly progressive, symmetric, extremity weakness, facial diplegia, ophthalmoplegia, respiratory insufficiency, and sensory ataxia over a 3-week period. Electrodiagnostic studies were performed on days 6, 13, and 50 following the onset of weakness. Motor nerve conduction abnormalities were the predominant findings. Prolonged motor distal latencies, prolonged or absent F waves, and partial motor conduction blocks were present and form the diagnostic features of an acquired, demyelinating polyneuropathy. Abnormalities in sensory nerve conductions and blink reflexes were also present. Guillain–Barré syndrome was diagnosed prompting the initiation of therapeutic plasma exchange. The patient's clinical status continued to worsen over the next 10 days before stabilizing. Considerable improvement in extremity strength, ocular motility, and respiratory function occurred in the subsequent weeks. Well-planned and well-executed electrodiagnostic studies generate key adjunctive data to the clinical diagnosis of Guillain–Barré syndrome. © 1999 American Association of Electrodiagnostic Medicine. Muscle Nerve 22: 271–281, 1999