The neurophysiological lesson from the Italian CIDP database.

Autor: Spina E; Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Via Pansini, 5, 81025, Naples, Italy. ema.spina@libero.it., Doneddu PE; Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy., Liberatore G; Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy., Cocito D; Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Turin, Italy., Fazio R; Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy., Briani C; Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy., Filosto M; Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST 'Spedali Civili', University of Brescia, Brescia, Italy., Benedetti L; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS San Martino, Genoa, Italy.; IRCCS AOU San Martino-IST, Genoa, Italy., Antonini G; Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy., Cosentino G; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.; IRCCS Foundation C. Mondino National Neurological Institute, Pavia, Italy., Jann S; Department of Neuroscience, Niguarda Ca' Granda Hospital, Milan, Italy., Mazzeo A; Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy., Cortese A; IRCCS Foundation C. Mondino National Neurological Institute, Pavia, Italy.; Molecular Neurosciences, University College London, London, UK., Marfia GA; Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy., Clerici AM; Neurology Unit, Circolo & Macchi Foundation Hospital, Insubria University, DBSV, Varese, Italy., Siciliano G; Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy., Carpo M; Neurology Unit, ASST Bergamo Ovest-Ospedale Treviglio, Treviglio, Italy., Luigetti M; Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy., Lauria G; Unit of Neuroalgology, IRCCS Foundation 'Carlo Besta' Neurological Institute, Milan, Italy.; Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy., Rosso T; ULSS2 Marca Trevigiana, UOC Neurologia-Castelfranco Veneto, Treviso, Italy., Cavaletti G; School of Medicine and Surgery and Experimental Neurology Unit, University of Milano-Bicocca, Monza, Italy., Peci E; Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Turin, Italy., Tronci S; Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy., Ruiz M; Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy., Piccinelli SC; Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST 'Spedali Civili', University of Brescia, Brescia, Italy., Schenone A; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS San Martino, Genoa, Italy., Leonardi L; Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy., Gentile L; Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy., Piccolo L; IRCCS Foundation C. Mondino National Neurological Institute, Pavia, Italy., Mataluni G; Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy., Santoro L; Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Via Pansini, 5, 81025, Naples, Italy., Nobile-Orazio E; Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy.; Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy., Manganelli F; Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Via Pansini, 5, 81025, Naples, Italy. fioremanganelli@gmail.com.
Jazyk: angličtina
Zdroj: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2022 Jan; Vol. 43 (1), pp. 573-582. Date of Electronic Publication: 2021 May 21.
DOI: 10.1007/s10072-021-05321-z
Abstrakt: Introduction: Electrophysiological diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) may be challenging. Thus, with the aim ofproviding some practical advice in electrophysiological approach to a patient with suspected CIDP, we analyzed electrophysiological data from 499 patients enrolled inthe Italian CIDP Database.
Methods: We calculated the rate of each demyelinating feature, the rate of demyelinating features per nerve, the diagnostic rate for upper andlower limb nerves, and, using a ROC curve analysis, the diagnostic accuracy of each couple of nerves and each demyelinating feature, for every CIDP subtype.Moreover, we compared the electrophysiological data of definite and probable CIDP patients with those of possible and not-fulfilling CIDP patients, and by a logisticregression analysis, we estimated the odds ratio (OR) to make an electrophysiological diagnosis of definite or probable CIDP.
Results: The ulnar nerve had the highestrate of demyelinating features and, when tested bilaterally, had the highest diagnostic accuracy except for DADS in which peroneal nerves were the most informative.In possible and not-fulfilling CIDP patients, a lower number of nerves and proximal temporal dispersion (TD) measurements had been performed compared to definiteand probable CIDP patients. Importantly, OR for each tested motor nerve and each TD measurement was 1.59 and 1.33, respectively.
Conclusion: Our findingsdemonstrated that the diagnosis of CIDP may be missed due to inadequate or incomplete electrophysiological examination or interpretation. At the same time, thesedata taken together could be useful to draw a thoughtful electrophysiological approach to patients suspected of CIDP.
(© 2021. The Author(s).)
Databáze: MEDLINE
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