Utility Of Nerve Conduction Studies Research Articles

Comparison of the diagnostic accuracy of the 2021 EAN/PNS and 2010 EFNS/PNS diagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy

ObjectivesTo compare the sensitivity and specificity of the 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) diagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with those of the 2010 European...

Monoclonal Gammopathies of 'Neurological Significance': Paraproteinemic Neuropathies.

To study the clinical profile and outcomes of patients with paraproteinemic neuropathy (PPN) and to explore the utility of nerve conduction studies (NCSs) to differentiate between the demyelinating subtypes. We did a retrospective analysis of patients diagnosed with PPN between January 2010 and December 2019 in an inpatient setting. The study population consisted of patients above 16 years of age presenting with clinical features suggestive of chronic peripheral neuropathy and on evaluation was found to have PPN. A total of 74 patients were identified. The patients were predominantly in the 6th decade, and the majority were males. The subtypes of PPN were monoclonal gammopathy of undetermined significance (MGUS) (45.9%), POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes) (24.3%), solitary plasmacytoma (17.6%), multiple myeloma (8.1%), and AL amyloidosis (4.1%). There are specific features on NCS which can help in identifying POEMS syndrome and IgM MGUS. The majority of patients with PPN tend to stabilize or improve with treatment; however, many have a severe residual disability. New terminology and classification of these entities as 'monoclonal gammopathies of neurological significance' can aid in early diagnosis and the development of effective treatment, to prevent residual disability. PPN has a heterogeneous spectrum of clinical, biochemical, and electrophysiological features. NCS can help distinguish POEMS syndrome and IgM MGUS from other demyelinating subtypes.

Utility of nerve conduction studies and ultrasonography in ulnar neuropathies at the elbow of different severity

ObjectiveTo report the sensitivity and the ability to precisely localize ulnar neuropathies at the elbow (UNE) of different severity by ultrasonography (US) and compare it to standard 10-cm nerve conduction studies (NCSs), and 2-cm short-segment NCSs (SSNCSs) across the elbow. MethodsIn a group of consecutive UNE patients, a prospective and blinded study was performed. The evaluation included clinical examination, electrodiagnostic (EDx) and US studies. We compared US and NCSs for sensitivity and the ability to precisely localize the UNE of different clinical severity. ResultsWe studied 202 affected arms of 197 UNE patients. Clinically very mild UNE was diagnosed in seven, mild in 43, moderate in 99 and severe in 53 arms. The sensitivities of SSNCSs were 14%, 67%, 93% and 100%, of 10-cm NCSs, 29%, 44%, 80% and 96%, and of US 14%, 47%, 59% and 89%, respectively. Precise UNE localization was possible using SSNCSs in 29%, 56%, 78% and 85%, and using US in 29%, 44%, 70% and 98%, respectively. ConclusionThe present study demonstrated that NCSs are more sensitive than US for the diagnosis of UNE of all clinical grades of severity. US was more efficient in localizing clinically severe, and SSNCSs in localizing mild or moderate UNE. SignificanceWe recommend SSNCSs as the first confirmatory test in UNE across all grades of severity.

The Sensitivity and Specificity of Nerve Conduction Studies for Diagnosis of Carpal Tunnel Syndrome: A Systematic Review.

Background: The utility of nerve conduction studies (NCS) for diagnosis of carpal tunnel syndrome (CTS) has continued to be a subject of debate. Proponents of NCS assume a high sensitivity and specificity; however, many are unaware of the actual literature on this topic and the cutoff values commonly used for diagnosis. The purpose of this systematic review of the literature is to report the sensitivity and specificity of NCS for diagnosis of CTS in various studies. Methods: A literature review of PubMed and EMBASE databases was performed for all articles on NCS for diagnosis of CTS. The outcome of interest was the sensitivity and/or specificity of the NCS distal motor latency (DML) or distal sensory latency (DSL) cutoff value used to diagnose CTS in each study. Results: A total of 3066 total articles were screened and 21 were included in the review after assessment by two independent reviewers. The mean cut-off value for DSL was 3.37 ms (range 2.8-4 ms) and the mean cutoff value for DML was 4.28 ms (range 3.8-4.6 ms). Weighted mean DSL sensitivity was 73.4% and weighted mean DSL specificity was 93.6%. Weighted mean DML sensitivity was 56.2% and weighted mean DML specificity was 95.8%. Conclusions: There is significant variation in the cutoff values used for both DSL and DML. The wide range of cut-off values makes it difficult to interpret the literature, and there is a lack of high-quality studies with control groups using a priori cut-off values for diagnosis.

A Study on the Utility of Nerve Conduction Studies in the Diagnosis of Subclinical Diabetic Peripheral Neuropathy

A Study on the Utility of Nerve Conduction Studies in the Diagnosis of Subclinical Diabetic Peripheral Neuropathy

Utility of nerve conduction studies for diagnosis of injury to the medial branch of the superficial radial nerve.

IntroductionThe clinical utility of nerve conduction study (NCS) for the distal medial branch of the superficial radial nerve (SRN) has not yet been clarified. Therefore, we investigated the clinical utility of NCS in patients with suspected SRN injury and compared the results with those in healthy control subjects.MethodsBilateral NCS of the medial branch of the SRN was performed in two patients with suspected injury of the medial branch of the SRN, and in 20 healthy control subjects. A surface recording electrode was placed at the medial side of the metacarpophalangeal joint of the thumb. The SRN was then stimulated at a location 12 cm proximal from the recording electrode.ResultsThe mean sensory nerve action potential in the two patients was significantly lower than that of the controls (6.75 ± 0.92 vs. 23.8 ± 8.2 μV, P < 0.05). The side-to-side differences in sensory nerve action potential in the two patients were significantly higher than in the controls (55 ± 7.1 vs. 11 ± 7.8%, P < 0.05).ConclusionsNCS may be useful for diagnosing injury of the medial branch of the SRN.

Abnormal Nerve Conduction Parameters in Young Diabetic Patients at Diagnosis

Background and Objectives: Diabetes in the young patients, less than 30 years of age, usually has sudden onset and severe hyperglycemia who are resistant to ketosis. Taking the advantage of this uniqueness of this group of patients the present study was aimed to evaluate their peripheral nerve functional status, explore its relationship with glycemic status and find out utility of nerve conduction study for detection of neuropathy at diagnosis to introduce timely intervention in the necessary cases.Materials and Methods: A total number of 32 newly diagnosed untreated diabetic patients, age 30 years or less, consecutively attending the BIRDEM Out-patient department were recruited. Age-matched healthy subjects (n=30) with no family history of diabetes served as controls. Motor and sensory conduction velocities (NCV), distal latencies (DL), compound muscle and sensory nerve action potentials (CAMP, SNAP) of ulnar, peroneal and sural nerves were studied following standard protocol. Glucose was determined by glucose-oxidase, Fructosamine by enzymatic colorimetric method.Results: Ulnar motor NCV (m/sec, mean±SD) was significantly slower in diabetic group compared to the controls [58.29±6.88 vs 66.56±6.13; p&lt;0.001]. CAMP [(?v, median] of ulnar nerve was significantly lower in diabetic patients [4.5 vs 5.8; p&lt;0.05]. Motor nerve conduction velocity of peroneal nerve was significantly slower (p&lt;0.0001) in diabetic patients. Peroneal nerve CMAP [?v, median] amplitude showed similar trends [5.5 vs 8.7 p&lt;0.001]. Sural sensory NCV was significantly slower [35.22±14.04 vs 42.38±8.52; p&lt;0.05] in diabetic patients. Peroneal nerve conduction velocity showed significant negative correlation with fasting glucose (r= -0.456, p&lt;0.001). Peroneal motor distal latency showed positive correlation with serum fructosamine value [r=0.439, p&lt;0.05]. Peroneal and ulnar NCV was negatively correlated [p&lt;0.001 and p&lt;0.05 respectively] with fructosamine. Sural sensory nerve action potential was also negatively correlated [r=-0.400 p&lt;0.05]. S. Fructosamine was negatively correlated with sensory ulnar nerve action potential.Conclusion: The result suggest that in the newly diagnosed untreated young diabetics of Bangladesh, abnormalities of nerve conduction parameters are detected early by doing nerve conduction study; motor nerve conduction parameters are affected more than sensory ones. Abnormal nerve conduction parameters seem to be related to degree of hyperglycaemia in early neuropathic patients.Birdem Med J 2015; 5(1): 14-19

The diagnostic utility of nerve conduction studies and skin biopsy for diabetic neuropathy (DPN): a Bayesian analysis (S17.008)

The diagnostic utility of nerve conduction studies and skin biopsy for diabetic neuropathy (DPN): a Bayesian analysis (S17.008)

The diagnostic utility of nerve conduction studies and skin biopsy for diabetic neuropathy (DPN): a Bayesian analysis (S42.007)

The diagnostic utility of nerve conduction studies and skin biopsy for diabetic neuropathy (DPN): a Bayesian analysis (S42.007)

Przydatność badań neurograficznych u chorych z neuropatią cukrzycową

Przydatność badań neurograficznych u chorych z neuropatią cukrzycową

Utility of nerve conduction study in early diagnosis of carpal tunnel syndrome (CTS)

Background: Carpal tunnel syndrome (CTS) is the commonest median nerve entrapment neuropathy with preponderance in females. Aims & Objective: The present study was carried out for early conformation of clinically diagnosed patients of Carpal Tunnel Syndrome (CTS) by electrodiagnostic tests which include motor conduction, sensory conduction, and F-wave studies. Materials and Methods: Early confirmation of clinically suspected patients of CTS by performing electrodiagnostic tests of median and ulnar nerves. 100 subjects of age group 30-50 years (50 clinically suspected patients of CTS, 50 as control group) were studied. Motor and Sensory conduction velocities, distal motor and sensory latencies and F wave latencies were performed using Medtronic Keypoint@ 2 EMG EP software. Results: Statistically significant (P

Early diagnosis of neuropathy in diabetic patients using nerve conduction studies

Background: Neuropathy is one of the common complications of diabetes, in which the patient’s quality of life is compromised. Nerve conduction studies (NCS) are not commonly employed to detect the neuropathy. Aims & Objective: To find out the utility of Nerve conduction studies (NCS) as early indicator of neuropathy in diabetic patients. Materials and Methods: 50 diabetes mellitus patients with normal HbA1c levels and 50 diabetes mellitus patients with elevated HbA1c levels were selected, making it a total of 100 diabetes mellitus patients. 50 non-diabetic, healthy subjects were chosen as a control group. The nerve conduction velocity was tested in all the diabetic subjects and the healthy controls. Results: The analysis showed that the nerve conduction velocity progressively decreased from the controls (49.0 ± 3.9) to the diabetics with a good glycaemia control (47.2 ± 2.8), to the diabetics with a poor glycemic control (45.3 ± 3.1). Conclusion: There is a progressive neuronal involvement in the diabetic process which is accelerated by poor glycemic control. Therefore, nerve conduction studies can be employed for testing and for the early indication of neuropathy in diabetic patients.

Electrophysiological changes in sensorimotor nerves in diabetes mellitus &amp; usefulness of nerve conduction studies for early diagnosis of diabetic neuropathy

Background: Diabetes Mellitus(DM) a metabolic disorder is the most common cause of peripheral neuropathy. Nerve conduction studies(NCS) are commonly employed to detect the neuropathy. The present study was undertaken to find out the utility of NCS as an early indicator of neuropathy in diabetic patients. Materials & methods: Study was carried out in 50 diagnosed DM patients attending OPD in Medicine, Civil Hospital, Ahmedabad. Diabetic subjects were selected having FBS >110 mg/dL with duration of DM > 5 years. Their HbA1c levels were measured for glycaemic control. Diabetic patients with good glycaemic control were grouped in group A & that with poor glycaemic control in group B. 25 age matched non-diabetic & healthy subjects were selected for control group C. NCS was performed at Institute of Spine, Civil Hospital Campus, Ahmedabad. Nerve conduction parameters like compound muscle action potential(CMAP), sensory nerve action potential(SNAP), nerve conduction velocity(NCV) & distal latency(DL) were studied. Results: In our study there is increase in DL of peroneal, sural; median & ulnar sensory nerves in group B subjects. NCV of sensorimotor nerves is significantly decreased in group B subjects. SNAP of all nerves is reduced in group A & B. CMAP is reduced significantly in all nerves in group B. Conclusion: As DM progress further, it increases risk of neuronal involvement which can be accelerated by poor glycaemic control. Our result indicates demyelinating type of neuropathy with some changes of axonopathy. Therefore NCS is done for early detection of neuropathy in DM patients.

Applicability and Utility of Nerve Conduction Studies in Early Postnatal SMNΔ7 Mice (P03.046)

Applicability and Utility of Nerve Conduction Studies in Early Postnatal SMNΔ7 Mice (P03.046)

Distribution, clinical correlates and significance of axonal loss and demyelination in chronic inflammatory demyelinating polyneuropathy

The distribution of axonal loss and demyelination has rarely been studied in chronic inflammatory demyelinating polyneuropathy (CIDP). Whether electrophysiological parameters may represent clinically relevant biomarkers of disease activity in the disorder remains uncertain. The purpose of this study was (i) to ascertain the distribution of electrophysiological motor abnormalities to optimize the diagnostic utility of nerve conduction studies and (ii) to establish electro-clinical correlations in an attempt to find the potential parameters that could represent adequate biomarkers of disease activity and prognosis. The clinical and electrophysiological motor features of 31 prospectively recruited patients with clinically stabilized CIDP were analysed. Axonal loss predominated in the lower limbs, but demyelination was more common in the upper limbs. About 50% of all demyelinating abnormalities were detected in asymptomatic regions. Presence of weakness correlated with abnormal compound muscle action potential (CMAP) and abnormal motor nerve conduction velocity (MNCV). Degree of weakness and functional scores only consistently correlated with CMAP amplitudes. CMAP abnormality correlated with abnormal MNCV, abnormal distal motor latency (DML) and presence of conduction block (CB). However, although CMAP amplitudes also correlated with MNCVs and DMLs in raw values, they did not relate to the degree of CB. Electrodiagnosis of CIDP is optimized by extensive testing of upper limb nerves and of asymptomatic regions. Raw value CMAP amelioration and MNCV normalization may be adequate markers of clinical improvement in CIDP. Similarly, raw value MNCV and DML amelioration, as well as CB reversal may represent adequate prognostic markers.

P2-8 Clinical utility of nerve conduction studies of the foot for the early detection of subclinical polyneuropathy in Japanese diabetic patients

P2-8 Clinical utility of nerve conduction studies of the foot for the early detection of subclinical polyneuropathy in Japanese diabetic patients

73. Diagnostic utility of nerve conduction studies for early diabetic neuropathy

73. Diagnostic utility of nerve conduction studies for early diabetic neuropathy

Medial plantar and dorsal sural nerve conduction studies increase the sensitivity in the detection of neuropathy in diabetic patients

Objective Clinical utility of nerve conduction studies (NCS) of the medial plantar and dorsal sural nerves in the early detection of polyneuropathy have already been shown separately. However, at present, there is no data about the combined assessment of these two nerves in distal sensory neuropathy. In the present study, we aimed to evaluate the medial plantar and dorsal sural NCS in a group of diabetic patients with distal sensory neuropathy (DSN) and in healthy controls. Methods Thirty healthy and 30 diabetic adult patients were included. In all subjects, peripheral motor and sensory NCS were performed bilaterally with surface electrodes on the lower limbs including medial plantar and dorsal sural nerves. In addition, motor and sensory nerves were studied unilaterally on the upper limb. Results In all patients, nerve action potential (NAP) amplitudes of sural and superficial peroneal nerves were within normal ranges, but in the patient group mean value was significantly lower than in the controls. Among clinically defined 30 DSN patients, medial plantar NAP amplitude was abnormal in 18 (60%) and dorsal sural nerve amplitude was abnormal in 13 (40%) of the patients bilaterally. Additionally, the onset NCV of the dorsal sural nerve was significantly slower in patients than controls ( P = 0.038). Evaluation of both of these nerves increased the sensitivity up to 70% in the detection of neuropathy. Conclusions Bilateral NCS assessment of both of the medial plantar and dorsal sural nerves together increases the rate of diagnosis of diabetic distal sensory neuropathy compared to assessment of either of these nerves. Significance Assessment of medial plantar in addition to dorsal sural NCS together increases the sensitivity in the detection of neuropathy and allows earlier diagnosis, especially when routine NCS are normal.

Utility of Nerve Conduction Studies for Carpal Tunnel Syndrome by Family Medicine, Primary Care, and Internal Medicine Physicians

Nerve conduction studies (NCS) are increasingly being performed at the point-of-service by family medicine, primary care, and internal medicine (FM/PCP/IM) physicians. Carpal tunnel syndrome (CTS) is a common neuropathy often diagnosed with the aid of NCS. A retrospective analysis of a point-of-service NCS data registry was conducted; 1190 patients who underwent NCS by 613 FM/PCP/IM physician practices, for evaluation of CTS were analyzed. Utility measures included demographic and electrophysiological characteristics of study population, adherence to evidence-based testing guidelines, and relevance of diagnostic outcomes. Tested patients tended to be over 40, female, and overweight or obese. The median nerve distal motor latency was 4.4 +/- 1.2 ms; 92.6% of studies met the testing guideline; 30.5% of tested limbs yielded normal results; 53.1% CTS; 5.4% ulnar neuropathy; and 11.0% nonspecific upper extremity neuropathy. This study demonstrated that point-of-service NCS by FM/PCP/IM physicians for CTS was applied to appropriate patient subpopulations, was performed in accordance with evidence-based testing parameters, and generated relevant diagnostic outcomes.

Usefulness of electrodiagnostic techniques in the evaluation of suspected tarsal tunnel syndrome: An evidence‐based review

This evidence-based review was performed to evaluate the utility of nerve conduction studies (NCSs) and needle electromyography (EMG) in the diagnosis of tibial neuropathy at the ankle (tarsal tunnel syndrome, TTS). A total of 317 articles on TTS were identified that were published in English from 1965 through April 2002, from the National Library of Medicine MEDLINE database. All articles were reviewed on the basis of six selection criteria. The results of this search revealed that four articles met five or more criteria. All four articles examined the use of electrodiagnostic (EDX) techniques for the evaluation of patients with clinically suspected TTS, and were included in this practice parameter. Each of these four studies was considered to meet Class III level of evidence. NCSs were abnormal in some patients with suspected TTS. Sensory NCSs were more likely to be abnormal than motor NCSs but the actual sensitivity and specificity could not be determined. The sensitivity of needle EMG abnormalities could not be determined. NCSs may be useful for confirming the diagnosis of tibial neuropathy at the ankle, recommendation Level C. Well-designed studies are needed to evaluate more definitively EDX techniques in TTS.