Nerve conduction patterns in guillainbarre syndrome associated with Zika virus infection
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INTRODUCTION: Zika virus (ZIKV) infection has been associated with Guillain-Barre syndrome (GBS), which diagnosis is clinical. However, NCSs provide information about subtypes, prognosis and outcomes OBJECTIVE: To evaluate NCS patterns in GBS-associated ZIKV. METHODS: This was a cross-sectional study in which 43 GBS patients (Brighton criteria) with ZIKV infection were included. NCS were evaluated according to new criteria set (AU). Motor conduction studies were evaluated in the median, ulnar, peroneal and tibial motor nerves whereas sensory nerve action potential and conduction velocity were measured in median, sural and ulnar nerves. F wave and H reflex were also registered. Statistical analysis was done in R 3.3.2. RESULTS: Demyelinating form represented 74.4percent-flag-change of the cases. AMAN and AMSAN forms were present in 6.9percent-flag-change and 2.3percent-flag-change of cases, respectively. The most observed pattern in AIDP were distal motor latency and decreased conduction velocity at left median nerve (p=0.013, p=0.038, respectively). In AMAN patients a decrease of the motor amplitude at right ulnar nerve was the highest (p=0.007). There was a prevalent distal involvement in AIDP patients. A major compromise of median nerve was distinctive (left: 63.6percent-flag-change, right: 71.4percent-flag-change). AGA were present in 6(26percent-flag-change) cases, and were not associated with any specific pattern. Agreement between Hadden's and Ho's criteria and Uncini's criteria was not found (Cohen's kappa coefficient-0.0024, 95percent-flag-change CI-0.13-0.13). SUMMARY/CONCLUSION: AIDP is the most frequent pattern of GBS associated with ZIKV infection. Also, AGA were not associated with any specific pattern in our population, more acute studies are needed. Furthermore, there is a lack of agreement between Hadden's criteria and new criteria set proposed by Uncini.
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