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Current perception threshold: an adjunctive test for detection of acquired demyelinating polyneuropathies.
Electromyogr Clin Neurophysiol. 2000 Jun; 40(4):205-10.EC

Abstract

Current Perception Threshold (CPT) evaluation quantifies the sensory threshold to transcutaneous electrical stimulation of three sensory fiber subtypes: A-beta (2,000 Hz), A-delta (250 Hz) and C fibers (5 Hz). Demyelinating polyneuropathies tend to affect larger myelinated fibers before smaller unmyelinated fibers, and they usually begin at the proximal nerve roots or terminal axons, due to relative weakness of the blood-nerve barrier in these locations. Axonal polyneuropathies tend to affect smaller fibers before larger fibers, in a distal to proximal gradient. Ten patients with demyelinating polyneuropathy and ten patients with axonal polyneuropathy underwent CPT testing. CPT comparisons were made with regard to side-to-side asymmetries, fiber type involvement, and the ratio of fiber types involved. The C2, lateral antebrachial cutaneous, and sural distributions were examined bilaterally. Demyelinating polyneuropathies were detected with 50% sensitivity and 100% specificity. This diagnostic sensitivity is similar to that of published criteria based upon motor nerve conduction. CPT testing can distinguish demyelinating from axonal polyneuropathies. It may be particularly helpful in patients with predominantly sensory symptoms in whom EMG/NCS data may be equivocal, or in patients who decline EMG/NCS studies.

Authors+Show Affiliations

Department of Neurology, University of Louisville School of Medicine, KY, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10907597

Citation

Menkes, D L., et al. "Current Perception Threshold: an Adjunctive Test for Detection of Acquired Demyelinating Polyneuropathies." Electromyography and Clinical Neurophysiology, vol. 40, no. 4, 2000, pp. 205-10.
Menkes DL, Swenson MR, Sander HW. Current perception threshold: an adjunctive test for detection of acquired demyelinating polyneuropathies. Electromyogr Clin Neurophysiol. 2000;40(4):205-10.
Menkes, D. L., Swenson, M. R., & Sander, H. W. (2000). Current perception threshold: an adjunctive test for detection of acquired demyelinating polyneuropathies. Electromyography and Clinical Neurophysiology, 40(4), 205-10.
Menkes DL, Swenson MR, Sander HW. Current Perception Threshold: an Adjunctive Test for Detection of Acquired Demyelinating Polyneuropathies. Electromyogr Clin Neurophysiol. 2000;40(4):205-10. PubMed PMID: 10907597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current perception threshold: an adjunctive test for detection of acquired demyelinating polyneuropathies. AU - Menkes,D L, AU - Swenson,M R, AU - Sander,H W, PY - 2000/7/25/pubmed PY - 2001/2/28/medline PY - 2000/7/25/entrez SP - 205 EP - 10 JF - Electromyography and clinical neurophysiology JO - Electromyogr Clin Neurophysiol VL - 40 IS - 4 N2 - Current Perception Threshold (CPT) evaluation quantifies the sensory threshold to transcutaneous electrical stimulation of three sensory fiber subtypes: A-beta (2,000 Hz), A-delta (250 Hz) and C fibers (5 Hz). Demyelinating polyneuropathies tend to affect larger myelinated fibers before smaller unmyelinated fibers, and they usually begin at the proximal nerve roots or terminal axons, due to relative weakness of the blood-nerve barrier in these locations. Axonal polyneuropathies tend to affect smaller fibers before larger fibers, in a distal to proximal gradient. Ten patients with demyelinating polyneuropathy and ten patients with axonal polyneuropathy underwent CPT testing. CPT comparisons were made with regard to side-to-side asymmetries, fiber type involvement, and the ratio of fiber types involved. The C2, lateral antebrachial cutaneous, and sural distributions were examined bilaterally. Demyelinating polyneuropathies were detected with 50% sensitivity and 100% specificity. This diagnostic sensitivity is similar to that of published criteria based upon motor nerve conduction. CPT testing can distinguish demyelinating from axonal polyneuropathies. It may be particularly helpful in patients with predominantly sensory symptoms in whom EMG/NCS data may be equivocal, or in patients who decline EMG/NCS studies. SN - 0301-150X UR - https://www.unboundmedicine.com/medline/citation/10907597/Current_perception_threshold:_an_adjunctive_test_for_detection_of_acquired_demyelinating_polyneuropathies_ DB - PRIME DP - Unbound Medicine ER -