The demyelination neurophysiological criteria can be misleading in Campylobacter jejuni-related Guillain-Barre syndrome

Objective: The exclusive association of Campylobacter jejuni infection with the axonal variant of Guillain-Barre syndrome (GBS) is debatable. The current study aims to elucidate the GBS subtypes of patients with an antecedent C. jejuni infection. Methods: Nerve conduction study results of 73 patients with GBS were reviewed. Patients were defined as having a recent C. jejuni infection when there was a positive stool culture or serological evidence of C. jejuni in the presence of preceding diarrhea. Results: A total of 23 patients had evidence of a recent C. jejuni infection. At the early stage, patients were classified as AMAN (n = 9; 39%), AIDP (n = 3; 13%) or equivocal (n = 9) using existing electrophysiological criteria. Prolonged distal latencies and conduction slowing that were seen in 11 patients rapidly normalized within 3 weeks in seven, whereas four had minor abnormalities throughout the course. Subsequently, all patients showed either acute motor axonal neuropathy pattern or reversible conduction failure. Conclusion: Serial neurophysiology suggests that C. jejuni infections are exclusive to axonal GBS. Significance: Our findings suggest that AMAN can demonstrate the full complement of demyelinating features at the early stages of disease. (C) 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.