{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T15:23:37Z","timestamp":1777994617839,"version":"3.51.4"},"reference-count":49,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T00:00:00Z","timestamp":1627344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>In its initial stages, Guillain\u2013Barr\u00e9 syndrome (GBS) is difficult to identify, because diagnostic criteria may not always be fulfilled. With this retrospective study, we wanted to identify the most common electrophysiological abnormalities seen on neurophysiological examination of GBS patients and its variants in the early phases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed the clinical records of patients admitted to our Neurology Unit with a confirmed diagnosis of GBS. The study sample was divided in two subgroups according to whether the neurophysiological examination was performed: within 7\u00a0days (very early group) or within 7\u201315\u00a0days (early group). H reflex, F waves, and motor and sensory conduction parameters were judged abnormal if they were outside the normal range for at least two nerves. We evaluated neurophysiological findings in Miller\u2013Fisher syndrome (MFS) separately.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study sample comprised 36 patients. In GBS, the most frequent abnormal neurophysiological parameter was the bilateral absence of the H reflex, followed by F wave abnormalities. Motor conduction parameters were altered in less than 50% of patients, and even less common were sensory nerve action potential reduction and the \"sural\u2010sparing\" pattern. In MFS, H reflex was absent bilaterally in 100% of patients, followed by a predominant peripheral sensory involvement, whereas motor conduction parameters were frequently normal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Bilateral absence of the H reflex is the most sensitive parameter in early diagnosis of GBS and its variants.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15011","type":"journal-article","created":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T18:32:52Z","timestamp":1625682772000},"page":"3768-3773","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Very early and early neurophysiological abnormalities in Guillain\u2013Barr\u00e9 syndrome: A 4\u2010year retrospective study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6443-5682","authenticated-orcid":false,"given":"Andrea","family":"Rasera","sequence":"first","affiliation":[{"name":"Department of Neurological, Neuropsychological, Morphological and Motor Sciences University of Verona Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Romito","sequence":"additional","affiliation":[{"name":"Neurology and Neurophysiology Unit Neuroscience Department University Hospital of Verona Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessia","family":"Segatti","sequence":"additional","affiliation":[{"name":"Neurology and Neurophysiology Unit Neuroscience Department University Hospital of Verona Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Concon","sequence":"additional","affiliation":[{"name":"Neurology and Neurophysiology Unit Neuroscience Department University Hospital of Verona Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Alessandrini","sequence":"additional","affiliation":[{"name":"Neurology and Neurophysiology Unit Neuroscience Department University Hospital of Verona Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Basaldella","sequence":"additional","affiliation":[{"name":"Neurology and Neurophysiology Unit Neuroscience Department University Hospital of Verona Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Badari","sequence":"additional","affiliation":[{"name":"Neurology and Neurophysiology Unit Neuroscience Department University Hospital of Verona Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Bonetti","sequence":"additional","affiliation":[{"name":"Neurology and Neurophysiology Unit Neuroscience Department University Hospital of Verona Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Squintani","sequence":"additional","affiliation":[{"name":"Neurology and Neurophysiology Unit Neuroscience Department University Hospital of Verona Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00339-1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000324710"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2014.138"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410270707"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awt285"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2010.06.003"},{"issue":"9","key":"e_1_2_10_8_1","first-page":"CD002063","article-title":"Intravenous immunoglobulin for Guillain\u2010Barr\u00e9 syndrome","volume":"19","author":"Hughes RAC","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2017.03.048"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2018.09.025"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.58.6.913"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2004.05.009"},{"key":"e_1_2_10_13_1","first-page":"S225","article-title":"Guidelines in electrodiagnostic medicine. 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