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Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
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A prospective multicentre study on sural nerve action potentials in ALS.

Kirsten Pugdahl1, Anders Fuglsang-Frederiksen, Birger Johnsen

  • 1Department of Clinical Neurophysiology, Aarhus University Hospital, Nørrebrogade 44, Aarhus C, Denmark.

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
|March 4, 2008
PubMed
Summary

Sensory nerve conduction studies in Amyotrophic Lateral Sclerosis (ALS) revealed minor abnormalities in 17% of patients. These mild sensory changes are not uncommon and do not exclude an ALS diagnosis.

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Area of Science:

  • Neurology
  • Neurophysiology

Background:

  • Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease primarily affecting motor neurons.
  • Sensory nerve involvement in ALS is typically considered minimal, with most patients exhibiting normal findings.

Purpose of the Study:

  • To prospectively evaluate sensory nerve conduction studies in a multicenter cohort of ALS patients.
  • To establish standardized protocols for assessing sensory potentials in ALS across European centers.

Main Methods:

  • A standardized protocol was used to obtain bilateral sural nerve potentials in 35 ALS patients and 35 controls.
  • Antidromic surface technique was employed, with reference values derived from the right sural nerve of controls.

Main Results:

  • Minor abnormalities in sensory nerve action potential (SNAP) amplitude or conduction velocity (CV) were observed in 17% of ALS patients.
  • Decreased CV was the most frequent abnormality, followed by reduced SNAP amplitude.
  • All detected changes were mild, ranging from -2.1 to -3.2 standard deviations below the control mean.

Conclusions:

  • This standardized multicenter study confirms that while normal sensory findings are expected in most ALS patients, minor abnormalities can occur.
  • Mild sensory abnormalities identified through nerve conduction studies do not preclude an ALS diagnosis.