116. Atypical AIDP with predominantly sensory involvement and increased duration of SAPs
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- 作者：F. Basaldella ; F. Donato ; C. Zuco ; G. Moretto ; S. Ottaviani ; T. Bovi ; S. Romito ; G.M. Squintani
- 刊名：Clinical Neurophysiology
- 出版年：2016
- 出版时间：April 2016
- 年：2016
- 卷：127
- 期：4
- 页码：e159
- 全文大小：31 K
文摘
The diagnosis of AIDP is based on clinical, electrophysiologic, and CSF data. Increased duration of cMAPs has been recently considered in the diagnosis of CIDP. However, the contribute of sensory neurography has not been well characterized. We describe a case of a 26 years old woman who came to our attention for oral and upper limb tingling which occurred ten days after flu-like symptoms and progressively extended to lower limbs. A first EMG revealed an increased distal latency of motor nerves and interestingly, a significantly increased duration (total and negative) of SAPs of median and ulnar nerves bilaterally. At admission, neurological examination revealed diffuse hypopallestesia in the extremities and absence of OT reflexes in lower limbs. CSF examination revealed a mild hyperproteinorrachia (0,74 g/l, normal value < 0,45). The patient was treated with iv-IgG with clinical benefit. The increased duration of SAPs is dependent on distal temporal dispersion and may be considered a sign of focal distal demyelination in sensory nerves. In conclusion, the duration of the distal SAPs may be considered an early and specific electrophysiologic feature of distal demyelination in sensory nerves, and may be relevant in patients with acute/chronic disimmune neuropathies with prevailing sensory deficits.