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Root stimulation improves the detection of acquired demyelinating polyneuropathies
D L Menkes1, D C Hood, R A Ballesteros
1Department of Neurology, University of Louisville, Kentucky 40292, USA.
Muscle & Nerve
|March 5, 1998
Summary
Root stimulation (RS) effectively identifies acquired demyelinating polyneuropathies and predicts treatment response. This method is superior to traditional criteria for diagnosing these neurological conditions.
Area of Science:
- Neurology
- Neurophysiology
Background:
- Acquired demyelinating polyradiculoneuropathies present diagnostic challenges.
- Traditional electrophysiologic criteria may not identify all affected individuals.
Purpose of the Study:
- To evaluate the efficacy of root stimulation (RS) in diagnosing acquired demyelinating polyradiculoneuropathies.
- To determine if RS can predict treatment response in these patients.
Main Methods:
- Prospective evaluation of 31 patients with suspected acquired demyelinating polyradiculoneuropathy.
- Application of root stimulation (RS) of cervical and/or lumbar roots.
- Comparison of RS findings with traditional electrophysiologic criteria and treatment outcomes.
Main Results:
- Proximal conduction block was identified in 20/31 patients using RS, while none of the 78 controls showed this.
- Only 7/31 patients met established demyelinating criteria.
- 20/21 patients who received intravenous immune globulin therapy responded.
Conclusions:
- Root stimulation (RS) is a superior electrophysiologic technique for identifying demyelinating polyneuropathies.
- RS reliably predicts response to immunosuppressive therapy, particularly intravenous immune globulin.
- RS should be utilized when traditional nerve conduction studies are inconclusive for diagnosing acquired demyelinating polyneuropathy.