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Abstract Details

Comparative Performance of Electrodiagnostic Criteria in Guillain-Barré Syndrome and the Impact of Machine-assisted Analysis
Neuromuscular and Clinical Neurophysiology (EMG)
P1 - Poster Session 1 (8:00 AM-9:00 AM)
9-001
To evaluate the diagnostic performance of current nerve conduction criteria for Guillain-Barré syndrome (GBS) across disease stages and assess whether integrating a machine-assisted electrodiagnostic (EDX) calculator based on the 2021 EAN/PNS CIDP criteria can improve diagnostic specificity.
Accurate early diagnosis of GBS remains challenging, as electrophysiologic findings may be subtle early after symptom onset, and traditional criteria often trade sensitivity for specificity. Umapathi and VEGBS criteria improve early detection but can yield false positives among mimics. Incorporating machine-based EDX support tools may refine specificity and aid clinical decision-making.

We retrospectively analyzed nerve conductions from 24 GBS and 68 controls admitted to Mayo Clinic (Rochester, MN, and Jacksonville, FL). Brighton level 1–2 criteria were met in GBS patients with symptom onset in 2 cases <5 days, 6 cases <8 days, 14 cases <15 days, and 12 cases >15 days. All 68 controls had GBS within the initial differential (26 other neuropathies, 16 myopathy, 12 generalized weakness, 5 MG, and 9 other neuromuscular diagnoses). Sensitivity and specificity were calculated using Umapathi and VEGBS criteria and compared with a machine-assisted calculator applying 2021 EAN/PNS CIDP possible and definite demyelinating criteria.

Umapathi criteria showed the highest early sensitivity (100% < 8 days) but low specificity (25%), while VEGBS maintained high specificity (93%) but poor early sensitivity (33% < 8 days). In contrast, the machine-assisted EAN/PNS CIDP criteria achieved moderate sensitivity (83% < 8 days) with improved specificity (69–71%), offering a better balance for diagnostic accuracy as disease duration increased.
Electrodiagnostic criteria are highly sensitive for GBS when applied early but lack specificity in isolation. Integrating machine-assisted tools applying 2021 CIDP criteria enhances specificity and supports clinical decision-making. Incorporating such tools into real-time EDX workflows may improve diagnostic accuracy and help distinguish GBS from mimics during acute presentations.
Authors/Disclosures
Jee Eun Oh, MBBS, FRACP (Grace Oh)
PRESENTER 		Dr. Oh has nothing to disclose.
Michael P. Skolka, MD Dr. Skolka has nothing to disclose.
Grace Swart, MD Dr. Swart has received research support from National Health and Medical Research Council. Dr. Swart has received personal compensation in the range of $5,000-$9,999 for serving as a MS Masters Forum Attendee (sponsored education) with Merck.
Elke Schipani, MD Dr. Schipani has nothing to disclose.
Shahar Shelly, MD (Rambam Medical Center) Dr. Shelly has or had stock in Remepy.
Stefan Stalberg Mr. Stalberg has received personal compensation for serving as an employee of Stefan Stalberg Software AB.
Benjamin Stalberg Mr. Stalberg has received personal compensation for serving as an employee of BenZoft.
Abe Gardner (Cadwell Laboratories, Inc) No disclosure on file
Jacob Price Mr. Price has received personal compensation for serving as an employee of Cadwell.
Divyanshu Dubey, MD, FAAN (Mayo Clinic) The institution of Dr. Dubey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. The institution of Dr. Dubey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys. The institution of Dr. Dubey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB . Dr. Dubey has received research support from Department of Defense . Dr. Dubey has received research support from Department of Defense . Dr. Dubey has received research support from UCB. Dr. Dubey has received research support from David J. Tomassoni ALS Research Grant Program . Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care.
Marcus Vinicius R. Pinto, MD (Mayo Clinic) Dr. Pinto has nothing to disclose.
Reece Hass, DO (Mayo Clinic, Rochester) Dr. Hass has nothing to disclose.
Jayawant N. Mandrekar, PhD Dr. Mandrekar has nothing to disclose.
Ruple S. Laughlin, MD, FAAN (Mayo Clinic Rochester) Dr. Laughlin has nothing to disclose.
William J. Litchy, MD, FAAN Dr. Litchy has nothing to disclose.
Christopher J. Klein, MD, FAAN (Mayo Clinic) Dr. Klein has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NMD Pharma.