This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective: To determine the occurrence of residual loss of peripheral nerve axons by motor unit number estimation (MUNE) and conventional nerve conduction studies (NCS) in patients with and without severe fatigue.
Methods: Thirty-nine patients at a median of 8 years (range 1–23 years) after diagnosis of Guillain-Barré syndrome were neurologically examined and divided in 2 subgroups based on the presence of severe fatigue (defined as a fatigue severity score ≥5). All patients were investigated with standard NCS and MUNE. Normal values for MUNE were collected in 14 healthy controls.
Results: MUNE of the thenar muscles was lower in the 15 patients with severe fatigue (median 125, interquartile range 65–141) compared with the 24 patients without severe fatigue (median 258, interquartile range 120–345) (p = 0.002). In the healthy controls, MUNE was 358 (245–416). Severe fatigue was also related to lower sensory nerve action potential amplitude of the median (p = 0.01) and ulnar nerve (p = 0.03). The 2 subgroups did not differ regarding neurologic deficits, disability, and the remaining conventional motor NCS.
Conclusion: This study demonstrates that severe fatigue after Guillain-Barré syndrome is related to more pronounced axonal loss, represented by lower MUNEs and lower sensory nerve action potentials.
GLOSSARY
- CMAP=
- compound muscle action potential;
- FSS=
- Fatigue Severity Scale;
- GBS=
- Guillain-Barré syndrome;
- HADS=
- Hospital Anxiety and Depression Scale;
- IQR=
- interquartile range;
- MRC=
- Medical Research Council;
- MU=
- motor unit;
- MUNE=
- motor unit number estimation;
- MUP=
- motor unit potential;
- NCS=
- nerve conduction studies;
- ODSS=
- overall disability sum score;
- SNAP=
- sensory nerve action potential
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
- Received May 17, 2013.
- Accepted in final form August 21, 2013.
- © 2013 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
- Re:Clinical fatigue in Guillain-Barre syndrome.
- Clinical fatigue in Guillain-Barre syndrome.
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Topics Discussed
Alert Me
Recommended articles
Longitudinal study of fiber density and motor unit number estimate in patients with amyotrophic lateral sclerosis
Patterns and serial changes in electrodiagnostic abnormalities of axonal Guillain–Barré syndrome
X-linked Charcot-Marie-Tooth disease with connexin 32 mutations
Motor axon loss is associated with hand dysfunction in Charcot-Marie-Tooth disease 1a