Electroneuromyographic Subtypes Of Guillain Barre Syndromes In Togo

Abstract

Introduction: The distribution of electroneuromyographic subtypes of Guillain Barré syndrome (GBS) differs by geographic region. Axonal forms predominate in Asia and South America while demyelinating forms predominate in Europe and North America. In sub-Saharan Africa, this distribution is not known. Objective: we proposed to report the forms of electroneuromyography encountered at the CHU Campus national reference center for Guillain Barré syndromes in Togo. Framework and methods: Data were collected retrospectively on files collected consecutively from November 1, 2013 to March 31, 2021. We included the records of patients in whom the clinic and the ENMG were unequivocal. The classification was made on the data of a spot review. The criteria of Rajabally al (2015) were used to distinguish between demyelinating, axonal, indeterminate and inexcitable subtypes. In addition, certain particular patterns have been sought to guide the classification: the "Sural spared" pattern defined as an absence of the sensory potentials of the median or ulnar with relative preservation of the sural, described as specific to the demyelinating subtype or the polyphasic, edentulous, dispersed aspects of the motor potentials testifying to a de-remyelination. Results: data from 44 patients, all Togolese, were retained. They had an average age of 38 years ± 20.13; with extremes 6 and 80 years. A female predominance was noted with a sex ratio of 0.5. The median time between enmg completion and onset of neurological disorders was 22.5 ± 8.07 days (ranges: 4 and 150 days). The following subtypes were found: demyelinating in 26 patients (59.09%), axonal in 16 patients (36.36%) and was inexcitable in two patients (4.55%). Diagnostic certainty was level one in 27 patients (61.36%) of patients and level two in 17 patients (38.64%). Conclusion: the demyelinating subtypes of GBS is the predominant in Togo followed by the AMAN subtype.

Keywords : Guillain Barré syndrome, electroneuromyography, ENMG, demyelinating, AMAN, Togo, Africa