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Published on: June 26, 2013
[Neurophysiologic studies of POEMS syndrome and its related diseases]
Yingsheng Xu1, Hongsong Song1, Shuo Zhang1
1Department of Neurology, Peking University Third Hospital, Beijing 100191, China.
Objective:
To explore the electrophysiological characteristics of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS) syndrome and its related diseases.
Methods:
The electrophysiological characteristics were analyzed retrospectively from June 2000 to June 2013 in patients with POEMS syndrome, monoclonal gammopathy of undetermined significance (MGUS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Electromyography and nerve conduction examinations of median, ulnar, tibial, peroneal and sural nerves were performed.
Results:
In patients with POEMS syndrome, the amplitude of compound muscle action potential (CMAP) of tibial and peroneal nerves was lower than that of median and ulnar nerves ((1.02 ± 0.23) vs (2.12 ± 0.30) mV, (P < 0.05) ); compared with patients with CIDP, the amplitude of CMAP for POEMS patients was lower ((2.12 ± 0.30) vs (3.94 ± 0.52) mV, (1.02 ± 0.23) vs (3.65 ± 0.57) mV) (P < 0.05) while terminal latency indices (TLI) was higher ((0.41 ± 0.13) vs (0.22 ± 0.01), (0.45 ± 0.16) vs (0.24 ± 0.13) ) (P < 0.05) and the occurring rate of conduction block (CB) and temporal dispersion (TD) was lower (P < 0.05). Compared with MGUS patients, the amplitude of CMAP for POEMS patients was lower ((2.12 ± 0.30) vs (3.81 ± 0.83) mV, (1.02 ± 0.23) vs (3.82 ± 0.63) mV) (P < 0.05) ; sensory conduction velocity of POEMS patients was faster ((33 ± 5) vs (20 ± 3) m/s, (28 ± 4) vs (18 ± 3) m/s)(P < 0.05)).
Conclusion:
Nerve conduction studies of POEMS syndrome implicate both axonal loss and demyelination.Uniform demyelination is more predominant in nerve trunk rather than distal nerve terminals. CB and TD occur less frequently and axonal loss is length-dependent.
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