Proprioceptive and Sympathetic Nerve Fibers Affection in Guillain-Barre Syndrome

Background autonomic affection is well known in Guillain Barre-. However, exact affection of proprioceptive fibers and sympathetic fibers are still not documented. Aim to investigate the magnitude of proprioceptive and sympathetic fibers involvement in patients with Guillan Barre- syndrome ( GBS) electrophysiologically. Design cross sectional study Setting outpatient setting Population twenty patients diagnosed as GBS and 20 healthy matched control were included Methods The proprioceptive Ia afferent fibers conduction velocity using electrically induced reflex activity (R1) and sympathetic skin response (SSR) were studied in upper and lower limbs of 20 patients fulfilling the criteria of GBS and 20 healthy volunteers. Results Median nerve proprioceptive Ia afferent fibers CV showed significant slowing in patients 29.517.4 m/s compared to control subjects 68.116.8m/s. Posterior tibial nerve proprioceptive Ia afferent fibers CV showed significant slowing in patients 3019.1m/s compared to control subjects57.416.1m/s. Nine patients (45 %) showed absent SSR in the hand, while 12 patients (60 %) showed absent SSR in the foot. Hand SSR showed significant delay 1.260.3 sec and decrease amplitude54.243.8v in patients compared to control1.080.2 sec, 99.464.4 v. Foot SSR showed significant delay1.8 v0.6 sec and decrease of amplitude 16.5 6.2 v in patients compared to control 1.6 0.2 sec, 36.5 23.8 v. Conclusions The study of electrically induced reflex activity revealed significant involvement of proprioceptive Ia afferent fibers in patients with GBS and was correlated significantly with the severity of neuropathy. SSR study showed significant involvement of sympathetic fibers in patients with GBS but not correlated with the severity of neuropathy.