Selective Vulnerability of Nerve Demyelination in Chronic Acquired Multifocal Polyneuropathy
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 18, Issue 5
Abstract
Introduction: Multifocal motor neuropathy (MMN), Lewis-Sumner syndrome (LSS) and many of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are representatives of acquired multifocal polyneuropathy and characterized by conduction block (CB). Objective: This retrospective study aimed to investigate the selective vulnerability and the demyelinating pattern of MMN, LSS and CIDP with CB (CIDP-CB) nerves. Methods: Fifteen LSS subjects (107 nerves), 24 MMN subjects (176 nerves) and 17 CIDP- CB subjects (110 nerves) were included. Their clinical information, blood and cerebrospinal fluid tests were collected, and nerve conduction were performed on median, ulnar, radial, peroneal and tibial nerves. CB, temporal dispersion (TD), distal motor latency (DML), F-wave latency were recorded and nerve conduction velocity (NCV), terminal latency index (TLI) and modified F-wave ratio (MFR) were calculated. Results: CB was more likely to occur around elbow (p<0.01) while less likely to be found between wrist and elbow in CIDP-CB (p<0.05). Tibial nerve CB was also frequently observed in MMN (p<0.05). CIDP-CB had a prolonged DML in all nerves and its slow motor nerve velocity (MCV) of upper limb was remarkable when CB nerves were excluded. Conclusion: We reported the difference of selective segmental vulnerability of ulnar and tibial nerves in LSS, MMN and CIDP-CB. The different CB distribution could help in differentiation.
Authors and Affiliations
Xiajun Zhou, Ying Zhu, Desheng Zhu, Lu Han, Qianyun Liu, Yong Hao, Zezhi Li, Yangtai Guan
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