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Neuromuscular ultrasound (NMUS) is emerging as a valuable non-invasive diagnostic tool. In GBS, NMUS can detect proximal nerve enlargement early, before neurophysiological changes. Persistent nerve enlargement can be observed up to 15 years, though its correlation with disability varies. Research is needed to clarify NMUS findings in GBS and CIDP over time. Early detection of nerve root enlargement via NMUS could facilitate earlier diagnosis and intervention, improving patient outcomes and understanding of these conditions' pathophysiology.
This study aims to determine if nerve alterations in acute GBS and CIDP detectable by ultrasound match electrodiagnostic findings and if this method aids early diagnosis. The investigators will perform serial nerve ultrasounds and NCS to investigate nerve morphology, predict outcomes, and differentiate between axonal and demyelinating subtypes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Case | Patients with immune mediated peripheral nerve disorders GB syndrome and CIDP |
| |
| Control | Healthy control matching group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Placebo | Dietary Supplement | Thiotacid 300 mg tab once/day |
|
| Measure | Description | Time Frame |
|---|---|---|
| Detection of Nerve Alterations via Ultrasound |
| 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of Nerve Morphology Evolution |
| 6 months |
| Prediction of Outcomes and Recovery |
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Inclusion Criteria:
Diagnosis of patient group:
Age: Participants aged 18 to 75 years.
Onset:
Gender: Both male and female participants are eligible.
Participation: Willingness to participate in the study, including undergoing disease-related examinations and assessments.
Consent: Ability and willingness to provide informed consent
Exclusion Criteria:
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A hospital-based study. Patients who are admitted to Assiut university hospitals, neuropsychiatry department.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mohammed Gad Ibrahim, MB, BCh | Contact | +201022748859 | 1022748859 | modyurd222@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Assiut University Hospitals | Recruiting | Asyut | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 17337484 | Background | Hughes RA, Swan AV, Raphael JC, Annane D, van Koningsveld R, van Doorn PA. Immunotherapy for Guillain-Barre syndrome: a systematic review. Brain. 2007 Sep;130(Pt 9):2245-57. doi: 10.1093/brain/awm004. Epub 2007 Mar 2. | |
| 14973982 | Background | Hughes RA, Raphael JC, Swan AV, Doorn PA. Intravenous immunoglobulin for Guillain-Barre syndrome. Cochrane Database Syst Rev. 2004;(1):CD002063. doi: 10.1002/14651858.CD002063.pub2. |
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Serum samples CSF samples
- Evaluate the potential of nerve ultrasound changes as predictors of clinical outcomes and recovery in GBS and CIDP patients. |
| 6 months |
| Differentiation of Subtypes | - Assess if early nerve ultrasound changes can differentiate between axonal and demyelinating subtypes of GBS and CIDP. | 6 months |
| Correlation with Clinical Scales | - Correlate ultrasound findings with clinical scales and outcomes, such as the Guillain-Barré Syndrome Disability Scale (GDS), Medical Research Council Sum Score (MRC sum score), and Erasmus GBS Outcome Scale (EGOS) | 6 months |
| Comparison with Healthy Controls | - Compare the ultrasound parameters of GBS and CIDP patients with age and sex-matched healthy controls to identify significant differences in nerve morphology | 6 months |
| 25238327 | Background | Hughes RA, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain-Barre syndrome. Cochrane Database Syst Rev. 2014 Sep 19;2014(9):CD002063. doi: 10.1002/14651858.CD002063.pub6. |
| 25023340 | Background | van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs BC, van Doorn PA. Guillain-Barre syndrome: pathogenesis, diagnosis, treatment and prognosis. Nat Rev Neurol. 2014 Aug;10(8):469-82. doi: 10.1038/nrneurol.2014.121. Epub 2014 Jul 15. |
| 26948435 | Background | Willison HJ, Jacobs BC, van Doorn PA. Guillain-Barre syndrome. Lancet. 2016 Aug 13;388(10045):717-27. doi: 10.1016/S0140-6736(16)00339-1. Epub 2016 Mar 2. |
| 9781538 | Background | Jacobs BC, Rothbarth PH, van der Meche FG, Herbrink P, Schmitz PI, de Klerk MA, van Doorn PA. The spectrum of antecedent infections in Guillain-Barre syndrome: a case-control study. Neurology. 1998 Oct;51(4):1110-5. doi: 10.1212/wnl.51.4.1110. |
| 35256276 | Background | Laman JD, Huizinga R, Boons GJ, Jacobs BC. Guillain-Barre syndrome: expanding the concept of molecular mimicry. Trends Immunol. 2022 Apr;43(4):296-308. doi: 10.1016/j.it.2022.02.003. Epub 2022 Mar 4. |
| 21422765 | Background | Sejvar JJ, Baughman AL, Wise M, Morgan OW. Population incidence of Guillain-Barre syndrome: a systematic review and meta-analysis. Neuroepidemiology. 2011;36(2):123-33. doi: 10.1159/000324710. Epub 2011 Mar 21. |
| ID | Term |
|---|---|
| D020275 | Guillain-Barre Syndrome |
| D020277 | Polyradiculoneuropathy, Chronic Inflammatory Demyelinating |
| D009443 | Neuritis |
| D010523 | Peripheral Nervous System Diseases |
| ID | Term |
|---|---|
| D011129 | Polyradiculoneuropathy |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D003711 | Demyelinating Diseases |
| D011115 | Polyneuropathies |
| D009468 | Neuromuscular Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D000094025 | Post-Infectious Disorders |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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