الفهرس 
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Abstract
drome (GBS) is a heterogeneous, immune mediated polyradiculoneuropathy. The main forms are acute inflammatory demyelinating polyradiculoneuropathy (AIDP), acute motor axonal neuropathy (AMAN), and acute sensorimotor axonal neuropathy (ASMAN). Each form has unique clinical, pathological and pathophysiological features.
The clinical spectrum ranges from mild symptoms to severe, rapidly progressing weakness with life threatening sequels (as respiratory paralysis and autonomic dysfunction). It has been demonstrated that an early diagnosis reduces the morbidity and improves the prognosis of the disease.
GBS diagnosis is usually clinical and requires the presence of progressive motor weakness of more than one limb and areflexia. Diagnosis is supported by electrodiagnosis (EDx), including nerve conduction studies (NCS) and electromyography (EMG).
The effect of timing on electrophysiology of GBS has been the object of several studies in recent years. These have consistently demonstrated a change in proportion of GBS subtypes with a described partial shift from acute inflammatory demyelinating polyneuropathy (AIDP) to axonal GBS. The benefit of serial studies has as a result been suggested and considered the gold-standard for diagnosis of GBS subtype.
As regard the needle electromyography (EMG) examination that is based on subjective assessment of the waveforms on the display screen. So, Quantitative electromyography methods have been developed to overcome these issues
Aim of the work is to assess the dynamic changes in NCS, conventional EMG, quantitative and concentric Macro-EMG techniques in early GBS. Also, this study aimed to detect sensitivity and specificity of each technique in predicting functional outcome of early GBS. This was conducted through prospective cohort study on 17 patients with GBS fulfilling criteria of it. The study was conducted at clinical neurophysiology unit in Kasr Al –Ainy Hospitals and in Benha University Hospitals.
Patients were subjected to the following:
1) Full medical history.
2) Neurological examination and disease severity will be evaluated by the GBS disability score Disease severity and muscle strength grade according to the MRC at admission and after three weeks
3) Electrophysiological studies: were done at admission and after three weeks
A. NCS were performed in the four limbs; motor NCS were routinely estimated in median, ulnar, tibial and peroneal nerves, and sensory NCS in median, ulnar, sural and superficial peroneal nerves. Conduction parameters were analyzed as follow: velocity, latency and amplitude (motor and sensory).Also, F wave latencies, ratio between pCMAP and dCMAP (either duration or amplitude), presence or absence of conduction block and temporal dispersion.
B. EMG:
• Conventional EMG examination using concentric needle electrodes was carried for the upper limb in abductor digiti minimi (ADM), biceps brachii muscles and lower limb in Tibialis anterior muscles. The main objectives of these studies were to detect insertional, spontaneous, MUAP activity, recruitment, and firing rate.
• QEMG was done in both upper and lower limbs in the previously mentioned muscle. And, at least 20 MUAP’s were recorded in each time and the MUAP direct parameters like ( amplitude, duration, number of phases , turns and area) were measured .Also, interference pattern analysis was done by asking the patient to do maximal effort to calculate turns/ amplitude ratio.
• Concentric macroEMG was done in both upper and lower limbs admission in the same muscle used for conventional EMG and QEMG. And, at least 20 MUAP’s were recorded.
C. Follow up evaluation will be done after 3weeks.
• Electrophysiological studies were performed in the four limbs (the same nerves and muscles) previously mentioned.
• Detection of reversibility of conduction block
Conclusion