Guillain-Barré syndrome diagnostic study of choice: Difference between revisions

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== Overview ==
== Overview ==
There is no single diagnostic study of choice for Guillain Barre syndrome, though GBS may be diagnosed based on NINDS criteria established by [[National Institute of Neurological Disorders and Stroke]]: Progressive ascending weakness or [[paralysis]] usually starting from legs, involving are 4 [[limbs]], the [[trunk]], [[bulbar]] and facial muscles, and external ocular muscles and [[Areflexia]] or decreased reflexes in affected limbs.


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==


=== Study of choice ===
=== Diagnostic Criteria ===
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* There is no single diagnostic study of choice for Guillain Barre syndrome, though GBS may be diagnosed based on NINDS criteria established by [[National Institute of Neurological Disorders and Stroke]]:<ref name="pmid2194422">{{cite journal |vauthors=Asbury AK, Cornblath DR |title=Assessment of current diagnostic criteria for Guillain-Barré syndrome |journal=Ann. Neurol. |volume=27 Suppl |issue= |pages=S21–4 |date=1990 |pmid=2194422 |doi= |url=}}</ref><ref name="pmid677829">{{cite journal |vauthors= |title=Criteria for diagnosis of Guillain-Barré syndrome |journal=Ann. Neurol. |volume=3 |issue=6 |pages=565–6 |date=June 1978 |pmid=677829 |doi=10.1002/ana.410030628 |url=}}</ref>
 
** Progressive ascending weakness or [[paralysis]] usually starting from legs, involving are 4 [[limbs]], the [[trunk]], [[bulbar]] and facial muscles, and external ocular muscles.
OR
** [[Areflexia]] or decreased reflexes in affected limbs.
 
* these findings can make the GBS diagnosis even more possible:
The following result of [gold standard test] is confirmatory of [disease name]:
** Progression of [[symptoms]] over days to four weeks
* [Result 1]
** Relative symmetry
* [Result 2]
** Sensory abnormalities
 
** Cranial nerve involvement, especially bilateral facial nerve weakness
OR
** Recovery starting two to four weeks after progression stops
 
** [[Autonomic dysfunction|Autonomic disturbance]]
[Name of the investigation] must be performed when:
** [[Pain]]
* The patient presents with [symptom/sign 1], [symptom/sign 2], and [symptom/sign 3].
** absence of fever in the acute phase
* A [name of test] is positive for [sign 1], [sign 2], and [sign 3] in the patient.
** Elevated [[CSF]] protein level
 
** CSF cell count ≤50/mm<sup>3</sup>
OR
** Electrodiagnostic abnormalities consistent with GBS
 
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
 
OR
 
The diagnostic study of choice for [disease name] is [name of the investigation].
 
OR
 
There is no single diagnostic study of choice for the diagnosis of [disease name].
 
OR
 
There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
 
OR
 
[Disease name] is primarily diagnosed based on the clinical presentation.
 
OR
 
Investigations:
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
 
==== The comparison of various diagnostic studies for [disease name] ====
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|}
<small> [Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity</small>
 
===== Diagnostic results =====
The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:
* [Finding 1]
* [Finding 2]
 
===== Sequence of Diagnostic Studies =====
The [name of investigation] must be performed when:
* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
* A positive [test] is detected in the patient, to confirm the diagnosis.
 
OR
 
The various investigations must be performed in the following order:
* [Initial investigation]
* [2nd investigation]
 
=== Name of Diagnostic Criteria ===
 
'''It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.'''
 
[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
 
OR
 
There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
 
OR
 
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
 
OR
 
The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
[Disease name] may be diagnosed at any time if one or more of the following criteria are met:
* Criteria 1
* Criteria 2
* Criteria 3
 
OR
 
'''IF there are clear, established diagnostic criteria'''
 
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
 
OR
 
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
'''IF there are no established diagnostic criteria'''
 
There are no established criteria for the diagnosis of [disease name].


==References==
==References==

Latest revision as of 16:53, 27 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

There is no single diagnostic study of choice for Guillain Barre syndrome, though GBS may be diagnosed based on NINDS criteria established by National Institute of Neurological Disorders and Stroke: Progressive ascending weakness or paralysis usually starting from legs, involving are 4 limbs, the trunk, bulbar and facial muscles, and external ocular muscles and Areflexia or decreased reflexes in affected limbs.

Diagnostic Study of Choice

Diagnostic Criteria

  • There is no single diagnostic study of choice for Guillain Barre syndrome, though GBS may be diagnosed based on NINDS criteria established by National Institute of Neurological Disorders and Stroke:[1][2]
    • Progressive ascending weakness or paralysis usually starting from legs, involving are 4 limbs, the trunk, bulbar and facial muscles, and external ocular muscles.
    • Areflexia or decreased reflexes in affected limbs.
  • these findings can make the GBS diagnosis even more possible:
    • Progression of symptoms over days to four weeks
    • Relative symmetry
    • Sensory abnormalities
    • Cranial nerve involvement, especially bilateral facial nerve weakness
    • Recovery starting two to four weeks after progression stops
    • Autonomic disturbance
    • Pain
    • absence of fever in the acute phase
    • Elevated CSF protein level
    • CSF cell count ≤50/mm3
    • Electrodiagnostic abnormalities consistent with GBS

References

  1. ↑ Asbury AK, Cornblath DR (1990). "Assessment of current diagnostic criteria for Guillain-Barré syndrome". Ann. Neurol. 27 Suppl: S21–4. PMID 2194422.
  2. ↑ "Criteria for diagnosis of Guillain-Barré syndrome". Ann. Neurol. 3 (6): 565–6. June 1978. doi:10.1002/ana.410030628. PMID 677829.

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