Comparison of 2-limb versus 3-limb electrodiagnostic studies in the evaluation of chronic inflammatory demyelinating polyneuropathy

• Published in: Muscle & nerve Vol. 51; no. 4; pp. 549 - 553
• Main Authors: Vo, Mary L., Hanineva, Aneliya, Chin, Russell L., Carey, Bridget T., Latov, Norman, Langsdorf, Jennifer A.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.04.2015; Wiley Subscription Services, Inc
• Subjects: Action Potentials - physiology; Adult; Aged; Aged, 80 and over; chronic inflammatory demyelinating polyneuropathy; Demyelinating Diseases - diagnosis; Demyelinating Diseases - physiopathology; demyelinating findings; electrodiagnosis; Electrodiagnosis - methods; Extremities - innervation; Extremities - physiopathology; Humans; Middle Aged; Neural Conduction - physiology; Peripheral Nerves - physiopathology; phenotype; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - diagnosis; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - physiopathology; Retrospective Studies; sensitivity; Sensitivity and Specificity; phenotype; chronic inflammatory demyelinating polyneuropathy; sensitivity; electrodiagnosis; demyelinating findings
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/mus.24424

ABSTRACT Introduction European Federation of Neurological Societies/Peripheral Nerve Society electrodiagnostic (EDx) criteria for the definite diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) require the presence of demyelinating findings (DF) in at least 2 nerves. Data are lacking, however, regarding the optimal number of nerves to test. Methods We retrospectively reviewed EDx data from 53 patients with CIDP and compared the number of DF found on 2‐ and 3‐limb testing. Results A median of 3 (range 2–5) DF were found on 2‐limb testing compared with 5 (range 4–7) DF when 3 limbs were evaluated. Two‐limb EDx studies were sufficient to diagnose definite CIDP in 92.3% of typical, 84.2% of asymmetric, and 66.7% of distal phenotypes. Testing a third limb increased diagnostic certainty in 11 patients (20.8%) to definite CIDP. Conclusions Three‐limb testing may increase diagnostic sensitivity of definite CIDP, especially in patients with atypical phenotypes. Larger prospective studies are needed to better assess the benefit of performing 3‐limb EDx studies. Muscle Nerve 51: 549–553, 2015