Neurology India Medknow Publications on behalf of the Neurological Society of India ISSN: 0028-3886 EISSN: 1998-4022 Vol. 57, Num. 5, 2009, pp. 690-690

Neurology India, Vol. 57, No. 5, September-October, 2009, pp. 690

Correspondence

"Finger drop sign" in Guillain Barré syndrome

Vimal K. Paliwal, Goel Gaurav

Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Correspondence Address: Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
dr_vimalkpaliwal@rediffmail.com

Date of Acceptance: 29-Aug-2009

Code Number: ni09198

PMID: 19934587

DOI: 10.4103/0028-3886.57781

To the Editor: We read with interest the article "Finger drop sign in Guillain Barré syndrome". ^[1] After reading the article we started examining our own patients with Gullian Barré Syndrome for this sign. Out of the four patients that we had in our ward at the time of reporting this, two had definite evidence of 'finger drop sign' with power of 3/5 and 4/5 in finger flexors and 0/5 and 1/5 in finger extensors respectively [Figure - 1]. On electrophysiological examination, both these patients as well as the other two with no 'finger drop sign' had acute inflammatory demyelinating polyradiculoneuropathy (AIDP) with demonstrable conduction blocks, delayed distal latencies and slowed conduction velocities. However, both the patients with positive 'finger drop sign' had normal sensory conductions. Both of the patients were given intravenous immunoglobulins (IVIg) as they had definite worsening during observation in the hospital. Both the patients showed improvement at the time of discharge. The other two did not receive IVIg and improved spontaneously. One of the patients with 'finger drop sign' could be examined one month after discharge from the hospital; at this stage there was no evidence of this sign but relatively more weakness was present in finger extensors (power grade 3/5) compared to flexors (power grade 4/5).

Though our observation in no way denigrates the scientifically carried out study published in your journal, it certainly needs more evaluation as has been pointed out in the commentary by Pradhan ^[2] that followed the article, particularly in terms of the specificity and sensitivity of this sign.

References

1.	George A, Abdurehiman P, James J. "Finger drop sign" in Guillain-Barré syndrome. Neurol India 2009;57:282-6.  Back to cited text no. 1  [PUBMED]
2.	Pradhan S. Invited Commentary. Neurol India 2009;57:281.  Back to cited text no. 2

Copyright 2009 - Neurology India

The following images related to this document are available:

Photo images