title: Diagnostic accuracy of neurophysiological criteria for early diagnosis of AIDP: A prospective study.
abstract: OBJECTIVE
  To assess the diagnostic accuracy of electrodiagnostic (EDX) criteria for the early detection and characterization of Guillain-Barré syndrome (GBS) in clinical practice.
  
  
  METHODS
  We conducted a prospective study in patients referred for an EDX exam with clinical suspicion of GBS. We evaluated four sets of neurophysiological criteria and four neurophysiological tests among those recently proposed for the early diagnosis of GBS.
  
  
  RESULTS
  We recruited 84 patients. Acute inflammatory demyelinating polyneuropathy (AIDP) was the final diagnosis in 23 patients. No axonal forms were found. The best sensitivity was obtained using Rajabally et al.'s criteria (82.1%), whereas the specificity was 90.0% for Ho et al.'s and Hadden et al.'s criteria and 100% for the Dutch GBS study group and Rajabally's criteria. Regarding the neurophysiological tests proposed for early diagnosis, the sensitivity ranged from 16.6 to 100%, whereas specificity ranged from 73.1 to 98.3%.
  
  
  CONCLUSIONS
  The Dutch GBS study group and Rajabally et al.'s criteria showed an optimal combination of sensitivity and specificity for clinical practice, although with a slightly higher sensitivity for Rajabally et al.'s criteria. None of the neurophysiological parameters recently proposed for early diagnosis have good diagnostic accuracy for clinical application.
  
  
  CONCLUSIONS
  In a real clinical setting with patients referred by neurologists and emergency doctors, an EDX study performed within a week of symptom onset supports the diagnosis of AIDP in 82% of cases.
authors.affiliation: Neuromuscolar Department, AOU Careggi, Florence, Italy; IRCCS Don Carlo Gnocchi, Florence, Italy.
authors.forename: Maenia
authors.initials: M
authors.lastname: Scarpino
authors.affiliation: Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Lolli
authors.affiliation: Neuromuscolar Department, AOU Careggi, Florence, Italy; IRCCS Don Carlo Gnocchi, Florence, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Carrai
authors.affiliation: Neuromuscolar Department, AOU Careggi, Florence, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lanzo
authors.affiliation: Neuromuscolar Department, AOU Careggi, Florence, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Spalletti
authors.affiliation: Neuromuscolar Department, AOU Careggi, Florence, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Barilaro
authors.affiliation: Department of Neurology and Psychiatry, University of Rome Sapienza, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fattapposta
authors.affiliation: Neuromuscolar Department, AOU Careggi, Florence, Italy; IRCCS Don Carlo Gnocchi, Florence, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Amantini
authors.affiliation: Neuromuscolar Department, AOU Careggi, Florence, Italy; IRCCS Don Carlo Gnocchi, Florence, Italy. Electronic address: agrippo@unifi.it.
authors.forename: Antonello
authors.initials: A
authors.lastname: Grippo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D004568:Electrodiagnosis; D005260:Female; D020275:Guillain-Barre Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Acute inflammatory demyelinating polyneuropathy; Cohort study; Electrodiagnosis; Guillain-Barré syndrome; Polyradiculoneuropathie aiguë inflammatoire démyélinisante; Syndrome de Guillain-Barré; Électroneuromyographie; Étude de cohorte