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

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== 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>
 
** 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 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==

Revision as of 18:49, 18 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

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]
    • 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.

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