The purpose of this study is to determine if peripheral nerve ultrasound can be used as a supplemental tool to diagnose Guillain-Barre syndrome (GBS) in the acute setting and aid in prognostication.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
20
Ultrasound of the bilateral ulnar nerves, median nerves, vagus nerves, and C6 and C7 nerve roots will be performed.
Strength will be assessed by physical examination and recorded using Medical Research Council (MRC) scale, and a hand dynamometer will be used to measure grip strength.
Duke University Hospital
Durham, North Carolina, United States
Internerve Variability of Cross-sectional Area (CSA) in Patients With GBS vs Controls
Internerve CSA variability for each patient will be calculated as: maximal intranerve CSA variability/minimal intranerve CSA variability. Intranerve CSA variability for each nerve will be calculated as: maximal CSA/minimal CSA for median and ulnar nerves.
Time frame: Day 0 and approximately 7 days after admission
Median Nerve Intranerve Cross-sectional Area (CSA) Variability in Patients With GBS vs Controls
Intranerve CSA variability for each nerve is calculated as: maximal intranerve CSA/minimal intranerve CSA . When both left and right ulnar nerves were scanned, the side with the largest intranerve CSA variability was used for analysis.
Time frame: Day 0 and approximately 7 days after admission
Ulnar Nerve Intranerve Cross-sectional Area (CSA) Variability in Patients With GBS vs Controls
Intranerve CSA variability for each nerve is calculated as: maximal intranerve CSA/minimal intranerve CSA . When both left and right ulnar nerves were scanned, the side with the largest intranerve CSA variability was used for analysis.
Time frame: Day 0 and approximately 7 days after admission
Length of Hospital Stay in Days
Length of hospital stay is measured to the nearest day (by chart review).
Time frame: Up to approximately 20 days
Ambulatory Status on Discharge
Number of participants with ambulatory status as "ambulatory with or without assistance".
Time frame: At discharge, up to approximately 20 days
Respiratory Dysfunction, as Measured by Number of Days Intubated
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Respiratory dysfunction will be measured by number of days intubated (to the nearest day) by chart review.
Time frame: During admission, up to approximately 20 days
Strength, as Measured by Hand Dynamometer
Average of left and right hand grip strength (in pounds).
Time frame: Day 0, Day 7
Strength, as Measured by Medical Research Council (MRC)
The Medical Research Council (MRC) total score ranges from 0-60, with higher values indicating greater muscle strength. The MRC total score is the sum score of the following muscle group subscales (each assessed on the left side and right side): bilateral shoulder abduction, elbow flexion, wrist extension, hip flexion, knee extension, and ankle dorsiflexion. Each muscle group subscale is rated 0-5, with 0 being no movement and 5 being full strength.
Time frame: Day 0, Day 7
Number of Participants With Autonomic Dysfunction
Autonomic dysfunction will be either present or absent by chart review during hospitalization.
Time frame: During hospitalization, up to approximately 20 days
Disability as Measured by the Guillain-Barre Syndrome (GBS) Disability Score
The GBS disability score ranges from 0-6 with lower scores indicating a better outcome (0 is healthy, 6 is death).
Time frame: Day 0, Day 7, Discharge (up to approximately 20 days), Day 90, Day 180