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The electrophysiological response to immunoglobulin therapy in chronic inflammatory demyelinating polyneuropathy
M Otto1, L Markvardsen2, H Tankisi1
1Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
Objective:
To characterize changes in motor nerve conduction studies (MNCS) and motor unit number index (MUNIX) following treatment with subcutaneous immunoglobulin and to assess whether these changes are related to muscle strength.
Methods:
Data from 23 patients participating in a randomized, controlled trial were analyzed. MNCS and MUNIX were performed before and after 12 weeks of treatment. Isokinetic strength (IMS) was measured in various muscles together with grip strength (GS).
Results:
Proximally evoked compound muscle action potential (CMAP) amplitudes and MUNIX tended to be better preserved in treated patients (P=.049 and .045). Changes in other parameters did not differ between groups. There was no correlation between changes in electrophysiological parameters and IMS. Changes in GS were related to median nerve motor conduction velocity, distal motor latency, CMAP amplitudes, and distally evoked CMAP duration (P=.013-.035).
Conclusion:
Proximally evoked CMAP amplitudes appear to be the best MNCS parameter to assess treatment outcome in chronic inflammatory demyelinating polyneuropathy.
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