GBS Mimics study

Update on the Dutch Guillain-Barré Syndrome Mimics Study

Introduction:

Early diagnosis is crucial in the Guillain-Barré syndrome (GBS), but may be complicated because of the heterogeneity in the clinical presentation, differential diagnosis and lack of a confirmative diagnostic tests. The Dutch GBS Mimics Study aims to (i) describe the differential diagnosis of GBS in current clinical practice, (ii) establish discriminating factors between GBS and its mimics and (iii) validate existing clinical criteria for GBS.

Methods:

The GBS Mimics Study is an ongoing national, multicenter, prospective cohort study in which all patients suspected of GBS can be included, including true cases of GBS but also patient having other diagnosis during follow-up. Detailed clinical and diagnostic data are collected at the time of first contact and the time of diagnosis. The diagnoses GBS or its mimic are checked for each patient by an independent team of neurologists.

Results:

From the preliminary analysis of the first 337 included patients, n = 193 (57%) had a final GBS diagnosis and n = 144 (43%) a GBS mimic. Frequent mimics of GBS were chronic inflammatory demyelinating polyneuropathy (n = 18), metabolic causes or deficiencies (e.g. vitamin deficiencies; n = 13), malignant or paraneoplastic diseases (n = 13),(post)infectious/auto-immune myelitis (n = 12) and infectious polyradiculitis (e.g., neuroborreliosis; n = 10). At time of first contact, limb weakness was present in 71% of GBS and 68% of GBS mimics patients. Hypo- or areflexia was seen more often in GBS (89%) than in GBS mimics patients (66%). More extensive analyses of potential discriminating clinical, electrophysiological and other factors will be presented at the upcoming PNS meeting.

Conclusions:

This study provides important insights into the differential diagnosis of GBS in current clinical practice. The study aims to define early distinguishing features between GBS and its mimics. Patient inclusion and data quality checks are ongoing. The results may help to improve the diagnostic process in daily practice, and may be valuable to evaluate existing clinical criteria.