Prolonged distal motor latency of median nerve does not improve diagnostic accuracy for CIDP.
CIDP
Carpal tunnel syndrome
Demyelination
Diagnostic accuracy
Neurophysiology
Journal
Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
20
04
2021
accepted:
14
06
2021
revised:
14
06
2021
pubmed:
27
6
2021
medline:
27
1
2022
entrez:
26
6
2021
Statut:
ppublish
Résumé
Compression of the median nerve at the carpal tunnel can give demyelinating features and result in distal motor latency (DML) prolongation fulfilling the EFNS/PNS demyelinating criteria for chronic inflammatory demyelinating polyneuropathy (CIDP). Accordingly, being carpal tunnel syndrome (CTS) common in the general population, the EFNS/PNS guidelines recommend excluding the DML of the median nerve when DML prolongation may be consistent with median neuropathy at the wrist from CTS. The main aims of this study were to verify whether the inclusion of DML of the median nerve (when consistent with CTS) could improve electrophysiological diagnostic accuracy for CIDP and if the median nerve at the carpal tunnel was more prone to demyelination. We analyzed electrophysiological data from 499 patients included consecutively into the Italian CIDP Database. According to the EFNS/PNS criteria, 352 patients had a definite, 10 a probable, and 57 a possible diagnosis of CIDP, while 80 were not fulfilling the diagnostic criteria. The inclusion of DML prolongation of median nerve did not improve significantly the diagnostic accuracy for CIDP; overall diagnostic class changed in 6 out of 499 patients (1.2%) and electrodiagnostic class of CIDP changed from not fulfilling to possible in only 2 patients (2.5% of not-fulfilling patients). In conclusion, we can infer that excluding DML prolongation of median nerve does not increase the risk of missing a diagnosis of CIDP thus corroborating the current EFNS/PNS criteria.
Identifiants
pubmed: 34173874
doi: 10.1007/s00415-021-10672-w
pii: 10.1007/s00415-021-10672-w
pmc: PMC8782796
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
907-912Investigateurs
Pietro Emiliano Doneddu
(PE)
Giuseppe Liberatore
(G)
Francesca Gallia
(F)
Eduardo Nobile-Orazio
(E)
None Rozzano
Erdita Peci
(E)
Dario Cocito
(D)
Stefano Tronci
(S)
Raffaella Fazio
(R)
San Raffaele
(S)
Fiore Manganelli
(F)
Lucio Santoro
(L)
Emanuele Spina
(E)
Enrica Pisano
(E)
Marta Ruiz
(M)
Chiara Briani
(C)
Stefano Cotti Piccinelli
(SC)
Massimiliano Filosto
(M)
Alessandro Beronio
(A)
Luana Benedetti
(L)
Antonio Toscano
(A)
Luca Gentile
(L)
Anna Mazzeo
(A)
Giorgia Mataluni
(G)
Girolama Alessandra Marfia
(GA)
Laura Piccolo
(L)
Elisa Vegezzi
(E)
Andrea Cortese
(A)
Giuseppe Cosentino
(G)
Brigida Fierro
(B)
Verrengia Elena Pinuccia
(VE)
Stefano Jann
(S)
Elisa Bianchi
(E)
Ettore Beghi
(E)
Angelo Maurizio Clerici
(AM)
Federica Scrascia
(F)
Marinella Carpo
(M)
Martina Garnero
(M)
Angelo Schenone
(A)
Marco Luigetti
(M)
Mario Sabatelli
(M)
Patrizia Dacci
(P)
Giuseppe Lauria
(G)
Luca Leonardi
(L)
Giovanni Antonini
(G)
Tiziana Rosso
(T)
Rika Schirinziand
(R)
Gabriele Siciliano
(G)
Claudia Balducci
(C)
Guido Cavaletti
(G)
Informations de copyright
© 2021. The Author(s).
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