Diagnostic value of sensory sparing patterns in childhood immune-mediated acute or chronic inflammatory polyneuropathy

Abstract

Objective To investigate the characteristics and significance of sural sparing pattern and radial sparing pattern in children immune-mediated acute or chronic inflammatory peripheral neuropathy. Methods Forty children with Guillain-Barre syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) aged 1 were conformed. SR=(sural nerve sensory nerve action potentials+radial nerve sensory nerve action potentials)/(median nerve sensory nerve action potentials+ulnar nerve sensory nerve action potentials). Results (1) In 40 patients from immune-inflammatory group, 38 were GBS and two were with CIDP; Among the 38 with GBS, 34 were with acute inflammatory demyelinating polyneuropathies (AIDP), 3 were with acute motor axonal neuropathy (AMAN), and one was with acute motor sensory axonal neuropathy. Among the 15 patients from the other etiologies group, 9 were with charcot-marie-tooth (CMT) type 1, one was with CMT type 2, one was with CMT intermediate type, and two were with hereditary neuropathy with liability to pressure palsies (HNPP), and two were with mitochondrial disease involves polyneuropathy. (2) As compared with patients from other etiologies group, patients from immune-inflammatory group had significantly higher positive rates of SS (72.5% vs. 6.7%), RS(42.5% vs. 6.7%) and SR>1 (75.0% vs. 13.3%). In the diagnoses of childhood acute or chronic inflammatory polyneuropathy, the sensitivity of SS pattern was 0.73, specificity was 0.93, and positive likelihood ratio was 10.88. SR>1 had moderate specificity (0.87) and low sensitivity (0.41). Conclusion The sensory sparing patterns, especially SS pattern, have valuable clinical significance in the diagnoses of acute or chronic inflammatory peripheral neuropathy in children. Key words: Guillain-Barre syndrome; Chronic inflammatory demyelinating polyradiculoneuropathy; Nerve conduction; Sural nerve; Radial nerve