학술논문
Prolonged distal motor latency of median nerve does not improve diagnostic accuracy for CIDP.
Document Type
Academic Journal
Author
Spina E; Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Via Pansini, 5, 81025, Naples, Italy. ema.spina@libero.it.; Doneddu PE; Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute, Rozzano, Milan, Italy.; Liberatore G; Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute, Rozzano, Milan, Italy.; Cocito D; Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Turin, Italy.; Fazio R; Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy.; Briani C; Department of Neuroscience, Neurology Unit, University of Padova, Padova, Italy.; Filosto M; Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST 'Spedali Civili', University of Brescia, Brescia, Italy.; Benedetti L; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS San Martino, Genoa, Italy.; IRCCS AOU San Martino-IST, Genoa, Italy.; Antonini G; Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, 'Sapienza' University of Rome, Rome, Italy.; Cosentino G; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.; IRCCS Mondino Foundation, Pavia, Italy.; Jann S; Department of Neuroscience, Niguarda Ca' Granda Hospital, Milan, Italy.; Mazzeo A; Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy.; Cortese A; IRCCS Mondino Foundation, Pavia, Italy.; Molecular Neurosciences, University College London, London, UK.; Marfia GA; Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.; Clerici AM; Neurology Unit, Circolo and Macchi Foundation Hospital, Insubria University, DBSV, Varese, Italy.; Siciliano G; Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.; Carpo M; Neurology Unit, ASST Bergamo Ovest-Ospedale Treviglio, Treviglio, Italy.; Luigetti M; UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.; Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy.; Lauria G; Unit of Neuroalgology, IRCCS Foundation 'Carlo Besta' Neurological Institute, Milan, Italy.; Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy.; Rosso T; ULSS2 Marca Trevigiana, UOC Neurologia-Castelfranco Veneto, Treviso, Italy.; Cavaletti G; School of Medicine and Surgery and Experimental Neurology Unit, University of Milano-Bicocca, Monza, Italy.; Peci E; Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Turin, Italy.; Tronci S; Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy.; Ruiz M; Department of Neuroscience, Neurology Unit, University of Padova, Padova, Italy.; Piccinelli SC; Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST 'Spedali Civili', University of Brescia, Brescia, Italy.; Schenone A; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS San Martino, Genoa, Italy.; Leonardi L; Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, 'Sapienza' University of Rome, Rome, Italy.; Gentile L; Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy.; Piccolo L; IRCCS Mondino Foundation, Pavia, Italy.; Mataluni G; Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.; Santoro L; Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Via Pansini, 5, 81025, Naples, Italy.; Nobile-Orazio E; Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute, Rozzano, Milan, Italy.; Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy.; Manganelli F; Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Via Pansini, 5, 81025, Naples, Italy.
Source
Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 0423161 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1459 (Electronic) Linking ISSN: 03405354 NLM ISO Abbreviation: J Neurol Subsets: MEDLINE
Subject
Language
English
Abstract
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.
(© 2021. The Author(s).)
(© 2021. The Author(s).)