Skip to main content

Advertisement

SpringerLink
Log in

Diagnosing chronic inflammatory demyelinating polyradiculoneuropathy with triple stimulation technique

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Objective

To assess the value of triple stimulation technique (TST) for diagnose of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

Methods

Seven clinically suspected CIDP patients who did not fulfill EFNS/PNS electrodiagnostic criteria for demyelinating neuropathy were enrolled in our study. Routine nerve conduction studies, lumbar puncture, spinal cord magnetic resonance imaging and TST were detected. The patients were being treated with oral prednisone starting at 1 mg/kg daily. The overall disability sum score was performed to evaluate the effect of corticosteroids.

Results

Twenty-eight motor nerves were tested with TST, two conduction blocks (CBs) were detected between the root emergence and the Erb point in six patients respectively and one CB was detected in one patient. Symptoms of all seven patients improved after treatment with oral prednisone.

Conclusion

TST can detect CBs located between the root emergence and the Erb point. TST is useful for early diagnosis of CIDP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Gerard S, Christian K (2013) Chronic inflammatory demyelinative polyneuropathy. Handb Clin Neurol 115:403–412

    Article  Google Scholar 

  2. Inaba A, Yokota T, Otagiri A, Nishimura T, Saito Y, Ichikawa T et al (2002) Electrophysiological evaluation of conduction in the most proximal motor root segment. Muscle Nerve 25:608–611

    Article  PubMed  Google Scholar 

  3. Arunachalam R, Osei-Lah A, Mills KR (2003) Transcutaneous cervical root stimulation in the diagnosis of multifocal motor neuropathy with conduction block. J Neurol Neurosurg Psychiatry 74:1329–1331

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Hitomi T, Kaji R, Murase N et al (2007) Dynamic change of proximal conduction in demyelinating neuropathies: a cervical magnetic stimulation combined with maximum voluntary contraction. Clin Neurophysiol 118:741–750

    Article  PubMed  Google Scholar 

  5. Feng JT, Zhu Y, Hua XY et al (2016) Diagnosing neurogenic thoracic outlet syndrome with the triple stimulation technique. Clin Neurophysiol 127(1):886–891

    Article  PubMed  Google Scholar 

  6. Deroide N, Uzenot D, Verschueren A et al (2007) Triple-stimulation technique in multifocal neuropathy with conduction block. Muscle Nerve 35(5):632–636

    Article  PubMed  Google Scholar 

  7. Attarian S, Azulay JP, Verschueren A et al (2005) Magnetic stimulation using a triple-stimulation technique in patients with multifocal neuropathy without conduction block. Muscle Nerve 32(6):710–714

    Article  PubMed  Google Scholar 

  8. Attarian S, Franques J, Elisabeth J et al (2015) Triple-stimulation technique improves the diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy. Muscle Nerve 51(4):541–548

    Article  PubMed  Google Scholar 

  9. Members of the Task Force, Van den Bergh PYK, Hadden RDM, Bouche P et al (2010) European Federation of Neurological Societies/Peripheral Nerve Society Guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society-first revision. J Peripher Nerv Syst 15:1–9

    Google Scholar 

  10. Magistris MR, Rosler KM, Truffert A et al (1999) A clinical study of motor evoked potentials using a triple stimulation technique. Brain 122:265–279

    Article  PubMed  Google Scholar 

  11. Rosler KM, Truffert A, Hess CW et al (2000) Quantification of upper motor neuron loss in amyotrophic lateral sclerosis. Clin Neurophysiol 111:2208 – 2218

    Article  PubMed  CAS  Google Scholar 

  12. Humm AM, Z’Graggen WJ, von Hornstein NE et al (2004) Assessment of central motor conduction to intrinsic hand muscles using the triple stimulation technique: normal values and repeatability. Clin Neurophysiol 115(11):2558–2566

    Article  PubMed  CAS  Google Scholar 

  13. Zheng JY, Xu YS, Fan DS (2011) Triple stimulation technique: normative value of Chinese adults. Chin J Neurol 44(11):739–741

    Google Scholar 

  14. Merkies IS, Schmitz PI, van der Meché FG et al (2002) Clinimetric evaluation of a new overall disability scale in immune mediated polyneuropathies. J Neurol Neurosurg Psychiatry 72(5):596–601

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. Graham RC, Hughes RAC (2006) A modified peripheral neuropathy scale: the Overall Neuropathy Limitations Scale. J Neurol Neurosurg Psychiatry 77:973–976

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  16. Nicolas G, Maisonobe T, Le Forestier N, Léger JM, Bouche P (2002) Proposed revised electrophysiological criteria for chronic inflammatory demyelinating polyradiculoneuropathy. Muscle Nerve 25(1):26–30

    Article  PubMed  Google Scholar 

  17. Haq RU, Fries TJ, Pendlebury WW, Kenny MJ, Badger GJ, Tandan R (2000) Chronic inflammatory demyelinating polyradiculoneuropathy: a study of proposed electrodiagnostic and histologic criteria. Arch Neurol 57(12):1745–1750

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by Medical scientific research of Chongqing Health and Family Planning Committee(2015MSXM004).

Author information

Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China

    Du Cao & Xiuming Guo

  2. Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Jie Hao

  3. Department of Neurology, 363 Hospital, Chengdu, China

    Ting Yuan

Author notes

  1. Du Cao and Jie Hao are co-first authors.

    Authors
    1. Du Cao
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Xiuming Guo
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Ting Yuan
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Jie Hao
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Xiuming Guo.

    Ethics declarations

    Conflicts of interest

    The authors declare no conflict of interest.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Cao, D., Guo, X., Yuan, T. et al. Diagnosing chronic inflammatory demyelinating polyradiculoneuropathy with triple stimulation technique. J Neurol 265, 1916–1921 (2018). https://doi.org/10.1007/s00415-018-8929-1

    Download citation

    • Received:

    • Revised:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s00415-018-8929-1

    Keywords

    Search

    Navigation