title: Sural sparing pattern discriminates Guillain-Barré syndrome from its mimics.
abstract: BACKGROUND
  Electrodiagnostic features of demyelination are essential for establishing the diagnosis in demyelinating subtypes of Guillain-Barré syndrome (GBS), but they may also occur in disorders that mimic GBS clinically. Information about their frequency in GBS mimics is sparse.
  
  
  METHODS
  Evaluation of electrodiagnostic features from 38 patients with suspected GBS in whom the diagnosis was later refuted (GBS mimics). Their diagnostic accuracy was analyzed by comparison with nerve conduction studies (NCS) from 73 confirmed GBS patients.
  
  
  RESULTS
  Disorders that mimicked GBS clinically at the time of hospital admission included other inflammatory, metabolic, toxic, or infectious neuropathies and spinal cord disorders. The sural sparing pattern was the most specific electrodiagnostic feature for demyelinating GBS.
  
  
  CONCLUSIONS
  Common electrodiagnostic abnormalities in early demyelinating GBS do not usually exclude other rare differential diagnoses. An exception to this is the sural sparing pattern described here, which strongly supports the diagnosis of demyelinating GBS.
authors.affiliation: Department of Neurology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany.
authors.forename: Angelika
authors.initials: A
authors.lastname: Derksen
authors.forename: Christian
authors.initials: C
authors.lastname: Ritter
authors.forename: Parveen
authors.initials: P
authors.lastname: Athar
authors.forename: Bernd C
authors.initials: BC
authors.lastname: Kieseier
authors.forename: Pedro
authors.initials: P
authors.lastname: Mancias
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Hartung
authors.forename: Kazim A
authors.initials: KA
authors.lastname: Sheikh
authors.forename: Helmar C
authors.initials: HC
authors.lastname: Lehmann
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004558:Electric Stimulation; D004568:Electrodiagnosis; D005260:Female; D020275:Guillain-Barre Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013497:Sural Nerve / Q000503:physiopathology*; D055815:Young Adult
keywords: GBS; Guillain-Barré syndrome; differential diagnosis; misdiagnosis; nerve conduction studies; peripheral neuropathy