Original Research| Volume 110, P48-52, April 2023

Sural nerve involvement in Guillain-Barré syndrome: Clinical and prognostic implications. A prospective cohort


      • 30 percent of patients with Guillain-Barré syndrome have affected sural nerve.
      • Patients with affected sural nerve do not present worse functional prognosis with respected sural nerve.
      • Age >50 years and Hughes scale ≥3 are risk factors for presenting sural nerve affected at admission in patients with Guillaín-Barre syndrome.



      Sural sparing is common in Guillain-Barré syndrome (GBS). However, one third of patients have sural nerve compromise. Its clinical implications associated factors and short-term prognosis are still unknown. The objective of this study is to identify if sural nerve compromise is associated with a worse prognosis and to describe clinical and electrophysiological characteristics in Guillain-Barré syndrome.

      Materials and methods

      We prospectively analyzed patients with Guillain-Barré diagnosis with vs without sural nerve compromise. All patients underwent nerve conduction studies within the first 3 days of hospital admission. Clinical and electrophysiological characteristics were compared between groups.


      174 patients were included in this study. Acute inflammatory demyelinating polyneuropathy was the predominant variant (43.7 %). Thirty percent of patients had sural nerve involvement. In the comparative analysis between affected vs unaffected sural groups, age ≥50 years and Guillain-Barré disability score ≥3 demonstrated a statistically significant difference. Regarding short-term recovery period for independent walking, there was no significant difference. In the multivariate analysis, age ≥50 years was identified as independent factors for sural nerve compromise on admission.


      sural nerve compromise occurs in 30 % of patients with GBS and is not associated with a worse functional prognosis. Age ≥50 years was identified as an independent factor for sural nerve compromise.


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