Sural nerve involvement in Guillain-Barré syndrome: Clinical and prognostic implications. A prospective cohort

J Clin Neurosci. 2023 Apr:110:48-52. doi: 10.1016/j.jocn.2023.01.003. Epub 2023 Feb 13.

Abstract

Background: Sural sparing is common in Guillain-Barré syndrome (GBS). However, one third of patients have sural nerve compromise. Its clinical implications associated factors and short-term prognosis are still unknown. The objective of this study is to identify if sural nerve compromise is associated with a worse prognosis and to describe clinical and electrophysiological characteristics in Guillain-Barré syndrome.

Materials and methods: We prospectively analyzed patients with Guillain-Barré diagnosis with vs without sural nerve compromise. All patients underwent nerve conduction studies within the first 3 days of hospital admission. Clinical and electrophysiological characteristics were compared between groups.

Results: 174 patients were included in this study. Acute inflammatory demyelinating polyneuropathy was the predominant variant (43.7 %). Thirty percent of patients had sural nerve involvement. In the comparative analysis between affected vs unaffected sural groups, age ≥50 years and Guillain-Barré disability score ≥3 demonstrated a statistically significant difference. Regarding short-term recovery period for independent walking, there was no significant difference. In the multivariate analysis, age ≥50 years was identified as independent factors for sural nerve compromise on admission.

Conclusion: sural nerve compromise occurs in 30 % of patients with GBS and is not associated with a worse functional prognosis. Age ≥50 years was identified as an independent factor for sural nerve compromise.

Keywords: Affected nerve sural; Clinical implications; Functional prognosis; Guillain-Barré syndrome; Sparing nerve sural.

MeSH terms

  • Electrophysiological Phenomena
  • Guillain-Barre Syndrome* / complications
  • Guillain-Barre Syndrome* / diagnosis
  • Humans
  • Middle Aged
  • Neural Conduction / physiology
  • Prognosis
  • Prospective Studies
  • Sural Nerve / physiology