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Chronic inflammatory demyelinating polyradiculoneuropathy: can a diagnosis be made in patients not fulfilling electrodiagnostic criteria?

Authors: Liberatore G.; Manganelli F.; Doneddu P. E.; Cocito D.; Fazio R.; Briani C.; Filosto M.; +71 Authors

Chronic inflammatory demyelinating polyradiculoneuropathy: can a diagnosis be made in patients not fulfilling electrodiagnostic criteria?

Abstract

AbstractBackground and purposeThe aim was to identify the clinical and diagnostic investigations that may help to support a diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in patients not fulfilling the European Federation of Neurological Societies and Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria.MethodsThe data from patients with a clinical diagnosis of CIDP included in a national database were retrospectively reviewed.ResultsIn all, 535 patients with a diagnosis of CIDP were included. This diagnosis fulfilled the EFNS/PNS criteria in 468 patients (87.2%) (definite in 430, probable in 33, possible in three, while two had chronic immune sensory polyradiculopathy). Sixty‐seven patients had a medical history and clinical signs compatible with CIDP but electrodiagnostic studies did not fulfill the EFNS/PNS criteria for CIDP. These patients had similar clinical features and frequency of abnormal supportive criteria for the diagnosis of CIDP compared to patients fulfilling EFNS/PNS criteria. Two or more abnormal supportive criteria were present in 40 (61.2%) patients rising to 54 (80.6%) if a history of a relapsing course as a possible supportive criterion was also included. Increased cerebrospinal fluid proteins and response to immune therapy most frequently helped in supporting the diagnosis of CIDP. Response to therapy was similarly frequent in patients fulfilling or not EFNS/PNS criteria (87.3% vs. 85.9%).ConclusionsPatients with a clinical diagnosis of CIDP had similar clinical findings, frequency of abnormal supportive criteria and response to therapy compared to patients fulfilling EFNS/PNS criteria. The presence of abnormal supportive criteria may help in supporting the diagnosis of CIDP in patients with a medical history and clinical signs compatible with this diagnosis but non‐diagnostic nerve conduction studies.

Country
Italy
Subjects by Vocabulary

Microsoft Academic Graph classification: Pediatrics medicine.medical_specialty Response to therapy Peripheral nerve Medicine Medical history In patient business.industry Polyradiculoneuropathy Polyradiculopathy medicine.disease Clinical diagnosis National database business

Keywords

Databases, Factual, Neural Conduction, Retrospective Studie, chronic inflammatory demyelinating polyradiculoneuropathy; diagnostic criteria; electrophysiology;, Humans, Peripheral Nerves, Retrospective Studies, chronic inflammatory demyelinating polyradiculoneuropathy, electrophysiology, Settore MED/26 - NEUROLOGIA, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating, Neurology, Peripheral Nerve, diagnostic criteria, chronic inflammatory demyelinating polyradiculoneuropathy; diagnostic criteria; electrophysiology, Neurology (clinical), Human

58 references, page 1 of 6

l 1. Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research

c 2. Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of

Naiples 'Federico II', Naples, Italy 3. Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Turin, Italy

t 4. Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology

r 5. Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy 6. Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST 'Spedali

Civili', University of Brescia, Brescia, Italy 7. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child

Health, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy 8. Neurology Unit, Sant'Andrea Hospital, La Spezia, Italy 9. Department of Clinical and Experimental Medicine, Unit of Neurology, University of

Messina, Messina, Italy 10. Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory

Santt'Andrea Hospital, Rome, Italy 11. Department of Experimental BioMedicine and Clinical Neurosciences (BioNeC), University

p 12. IRCCS Foundation C. Mondino National Neurological Institute, Pavia, Italy 13. Department of Neuroscience, Niguarda Ca' Granda Hospital, Milan, Italy

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  • citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    16
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
16
Top 10%
Average
Top 10%
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