Diagnosing chronic inflammatory demyelinating polyradiculoneuropathy with triple stimulation technique

J Neurol. 2018 Aug;265(8):1916-1921. doi: 10.1007/s00415-018-8929-1. Epub 2018 Jun 20.

Abstract

Objective: To assess the value of triple stimulation technique (TST) for diagnose of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

Methods: Seven clinically suspected CIDP patients who did not fulfill EFNS/PNS electrodiagnostic criteria for demyelinating neuropathy were enrolled in our study. Routine nerve conduction studies, lumbar puncture, spinal cord magnetic resonance imaging and TST were detected. The patients were being treated with oral prednisone starting at 1 mg/kg daily. The overall disability sum score was performed to evaluate the effect of corticosteroids.

Results: Twenty-eight motor nerves were tested with TST, two conduction blocks (CBs) were detected between the root emergence and the Erb point in six patients respectively and one CB was detected in one patient. Symptoms of all seven patients improved after treatment with oral prednisone.

Conclusion: TST can detect CBs located between the root emergence and the Erb point. TST is useful for early diagnosis of CIDP.

Keywords: CIDP; Conduction block; Triple stimulation technique.

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Disability Evaluation
  • Electrodiagnosis
  • Female
  • Glucocorticoids / administration & dosage
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neural Conduction
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnosis*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / drug therapy
  • Prednisone / administration & dosage
  • Spinal Cord / diagnostic imaging
  • Spinal Puncture

Substances

  • Glucocorticoids
  • Prednisone