Utility of the distal compound muscle action potential duration for diagnosis of demyelinating neuropathies

Sagiri Isose, Satoshi Kuwabara, Norito Kokubun, Yasunori Sato, Masahiro Mori, Kazumoto Shibuya, Yukari Sekiguchi, Saiko Nasu, Yumi Fujimaki, Yuichi Noto, Setsu Sawai, Kazuaki Kanai, Koichi Hirata, Sonoko Misawa

Research output: Contribution to journalArticlepeer-review

48 Citations (Scopus)

Abstract

To assess the significance of distal compound muscle action potential (CMAP) duration for diagnosis of demyelinating neuropathies, electrophysiologic data were reviewed from 471 subjects, including 145 normal controls, 60 patients with chronic inflammatory demyelinating polyneuropathy (CIDP), 205 with other neuropathy, and 61 with amyotrophic lateral sclerosis (ALS). The duration of distally evoked CMAP was measured in the median, ulnar, tibial, and peroneal nerves. Optimal cut-off values were calculated with receiver-operating characteristic (ROC) curves. In comparison of normal controls and CIDP patients, ROC analyses showed the sufficient area under the curves (82-93%). When the cut-off values in the detection of demyelination were determined as the point with 98% specificity vs. normal on the ROC curves (median, 6.6 ms; ulnar, 6.7 ms; peroneal, 7.6 ms; tibial, 8.8 ms), the sensitivity was 77% for CIDP, with a specificity of 90% vs. ALS and 95% vs. diabetic neuropathy. The distal CMAP duration is a useful index for the detection of distal demyelination. We suggest the above cut-off values for each nerve as one of the electrodiagnostic criteria for demyelinating neuropathies, preferentially affecting the distal nerve terminals, such as CIDP.

Original languageEnglish
Pages (from-to)151-158
Number of pages8
JournalJournal of the Peripheral Nervous System
Volume14
Issue number3
DOIs
Publication statusPublished - 2009 Sep 1
Externally publishedYes

Keywords

  • Acute inflammatory demyelinating polyneuropathy
  • Chronic inflammatory demyelinating polyneuropathy
  • Compound muscle action potential

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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