+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Atypical electrophysiologic findings in chronic inflammatory demyelinating polyneuropathy (CIDP)--diagnosis confirmed by nerve biopsy



Atypical electrophysiologic findings in chronic inflammatory demyelinating polyneuropathy (CIDP)--diagnosis confirmed by nerve biopsy



Neurophysiologie Clinique 34(2): 71-79



Numerous sets of electrophysiological criteria of chronic inflammatory demyelinating polyneuropathy (CIDP) have been proposed, among which the criteria established by an ad hoc subcommittee of the American Academy of Neurology (AAN) in 1991 (Neurology 41 (1991) 617) are the most widely used. As they seemed rather restrictive, the Inflammatory Neuropathy Cause and Treatment (INCAT) group (Ann. Neurol. 50 (2001) 195) proposed modifications of these electrophysiological criteria. However, even using these criteria, some cases of CIDP may not be recognized. In such cases, nerve biopsy has proven useful for confirmation of the diagnosis by demonstrating specific abnormalities. The objective of the study was to determine the profile of electrophysiological abnormalities in patients with atypical electrophysiologic criteria of CIDP and the diagnostic value of multiple A waves and a low median to sural amplitude ratio. Over a period of 3 years, we classified 44 patients into two categories: those presenting the strict AAN and/or INCAT criteria and those who we regarded as cases of CIDP not meeting these criteria. All patients benefited from one or more clinical and electrophysiological examination. Extensive biological workup and genetic study when appropriate excluded other causes of neuropathy. Nerve biopsies were taken from all patients and samples were included in paraffin and epon for systematic light, teasing and electron microscopic examination. Out of 44 patients, 36 fulfilled the INCAT or AAN criteria. In eight other patients, the diagnosis of CIDP was suspected on clinical and EMG examinations and confirmed by nerve biopsy. In these cases, the electrophysiological exploration showed some abnormalities such as multiple A waves in four out of eight patients or an abnormal pattern of the sensory responses of the median and sural nerves in four out of eight patients that were more indicative of an initial demyelinating process. Six of our patients received immunomodulatory treatment, and five responded favorably.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 048336561

Download citation: RISBibTeXText

PMID: 15130553

DOI: 10.1016/j.neucli.2004.01.004


Related references

Diagnostic value of nerve biopsy for atypical chronic inflammatory demyelinating polyneuropathy: evaluation of eight cases. Muscle and Nerve 27(4): 478-485, 2003

Nerve conduction abnormalities in chronic inflammatory demyelinating polyneuropathy (CIDP). Rinsho Shinkeigaku 31(12): 1333-1336, 1991

Nerve echogenicity and intranerve CSA variability in high-resolution nerve ultrasound (HRUS) in chronic inflammatory demyelinating polyneuropathy (CIDP). Journal of Neurology 266(2): 468-475, 2019

Sural nerve biopsy in chronic inflammatory demyelinating polyneuropathy: are supportive pathologic criteria useful in diagnosis?. Neurology India 58(4): 542-548, 2010

Demyelinating findings in typical and atypical chronic inflammatory demyelinating polyneuropathy: sensitivity and specificity. Journal of Clinical Neuromuscular Disease 10(4): 163-169, 2009

Importance of the nerve biopsy for the diagnosis of atypical forms of chronic inflammatory demyelinating polyradiculoneuritis: 8 cases. Bulletin de l'Academie Nationale de Medecine 187(2): 387-99; Discussion 399-403, 2003

S139. A retrospective study of patients with chronic inflammatory demyelinating polyneuropathy (Cidp): Identifying ultrasonographic features for diagnosis and prognosis. Clinical Neurophysiology 129: e193-e194, 2018

Chronic inflammatory demyelinating polyneuropathy (CIDP). Acta Neurologica Scandinavica. Supplementum 2013(196): 48-51, 2013

Chronic inflammatory demyelinating polyneuropathy (CIDP). Ryoikibetsu Shokogun Shirizu 1999(27 Pt 2): 479-482, 1999

Research criteria for diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP). Report from an Ad Hoc Subcommittee of the American Academy of Neurology AIDS Task Force. Neurology 41(5): 617-618, 1991

Clinical and electrophysiological characteristics of chronic inflammatory demyelinating polyneuropathy , CIDP with monoclonal gammopathy of uncertain significance and demyelinating neuropathy with antibodies to myelin associated glycoprotein. Neurology 50(4 Suppl. 4): A145, 1998

Chronic inflammatory demyelinating polyneuropathy (CIDP) in diabetics. Journal of the Neurological Sciences 142(1-2): 59-64, 1996

Treatment of chronic inflammatory demyelinating polyneuropathy (CIDP). Rinsho Shinkeigaku 36(12): 1336-1337, 1996

Chronic inflammatory demyelinating polyneuropathy (CIDP) associated with seminoma. European Neurology 39(1): 57-58, 1998

A child with chronic inflammatory demyelinating polyneuropathy (CIDP). Zhonghua Er Ke Za Zhi 41(9): 707-708, 2003