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Diagnostic utility of distal nerve conduction studies and sural near-nerve needle recording in polyneuropathy.
Clin Neurophysiol. 2017 09; 128(9):1590-1595.CN

Abstract

OBJECTIVE

The electrodiagnosis of polyneuropathy (PNP) may benefit from examination using near-nerve needle technique (NNT) and from inclusion of distal nerves. This study compared the diagnostic utility of distal nerve conduction studies (NCS) and NNT recording.

METHODS

Bilateral NNT and surface recording of the sural nerve and surface recording of the dorsal sural and medial plantar nerves were prospectively done in 91 patients with clinically suspected PNP. Distal NCS were additionally done in 37 healthy controls. Diagnostic reference standard was the final clinical diagnosis retrieved from the patients medical records after 1-4years.

RESULTS

The clinical follow-up diagnosis confirmed PNP in 68 patients. Equally high sensitivities of the dorsal sural (72%), medial plantar (75%), and sural nerve with NNT recording (77%) were seen, while the sensitivity of conventional surface recording of the sural nerve was lower (60%). Sural NCS with both NNT and surface recording and dorsal sural NCS showed high specificities (85-95%) and positive predictive values (94-98%), while a lower specificity was seen for the medial plantar nerve (68%).

CONCLUSION

NCS of distal nerves, especially the dorsal sural nerve, have high diagnostic power equalling sural NNT recording.

SIGNIFICANCE

The electrodiagnostic evaluation of patients with suspected PNP benefits from NCS of distal nerves.

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Authors+Show Affiliations

Kural MA
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
Karlsson P
Danish Pain Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Pugdahl K
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
Isak B
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
Fuglsang-Frederiksen A
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
Tankisi H
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: hatitank@rm.dk.

MeSH

Action PotentialsAdultAgedElectrodiagnosisFemaleFollow-Up StudiesHumansMaleMiddle AgedNeedlesNeural ConductionPolyneuropathiesProspective StudiesSural NerveTibial Nerve

Pub Type(s)

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

Language

eng

PubMed ID

28710923

Citation

Kural, Mustafa Aykut, et al. "Diagnostic Utility of Distal Nerve Conduction Studies and Sural Near-nerve Needle Recording in Polyneuropathy." Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, vol. 128, no. 9, 2017, pp. 1590-1595.
Kural MA, Karlsson P, Pugdahl K, et al. Diagnostic utility of distal nerve conduction studies and sural near-nerve needle recording in polyneuropathy. Clin Neurophysiol. 2017;128(9):1590-1595.
Kural, M. A., Karlsson, P., Pugdahl, K., Isak, B., Fuglsang-Frederiksen, A., & Tankisi, H. (2017). Diagnostic utility of distal nerve conduction studies and sural near-nerve needle recording in polyneuropathy. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, 128(9), 1590-1595. https://doi.org/10.1016/j.clinph.2017.06.031
Kural MA, et al. Diagnostic Utility of Distal Nerve Conduction Studies and Sural Near-nerve Needle Recording in Polyneuropathy. Clin Neurophysiol. 2017;128(9):1590-1595. PubMed PMID: 28710923.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic utility of distal nerve conduction studies and sural near-nerve needle recording in polyneuropathy. AU - Kural,Mustafa Aykut, AU - Karlsson,Páll, AU - Pugdahl,Kirsten, AU - Isak,Baris, AU - Fuglsang-Frederiksen,Anders, AU - Tankisi,Hatice, Y1 - 2017/06/27/ PY - 2017/04/04/received PY - 2017/05/16/revised PY - 2017/06/09/accepted PY - 2017/7/16/pubmed PY - 2017/9/1/medline PY - 2017/7/16/entrez KW - Dorsal sural nerve KW - Medial plantar nerve KW - Near-nerve technique KW - Nerve conduction study KW - Polyneuropathy SP - 1590 EP - 1595 JF - Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology JO - Clin Neurophysiol VL - 128 IS - 9 N2 - OBJECTIVE: The electrodiagnosis of polyneuropathy (PNP) may benefit from examination using near-nerve needle technique (NNT) and from inclusion of distal nerves. This study compared the diagnostic utility of distal nerve conduction studies (NCS) and NNT recording. METHODS: Bilateral NNT and surface recording of the sural nerve and surface recording of the dorsal sural and medial plantar nerves were prospectively done in 91 patients with clinically suspected PNP. Distal NCS were additionally done in 37 healthy controls. Diagnostic reference standard was the final clinical diagnosis retrieved from the patients medical records after 1-4years. RESULTS: The clinical follow-up diagnosis confirmed PNP in 68 patients. Equally high sensitivities of the dorsal sural (72%), medial plantar (75%), and sural nerve with NNT recording (77%) were seen, while the sensitivity of conventional surface recording of the sural nerve was lower (60%). Sural NCS with both NNT and surface recording and dorsal sural NCS showed high specificities (85-95%) and positive predictive values (94-98%), while a lower specificity was seen for the medial plantar nerve (68%). CONCLUSION: NCS of distal nerves, especially the dorsal sural nerve, have high diagnostic power equalling sural NNT recording. SIGNIFICANCE: The electrodiagnostic evaluation of patients with suspected PNP benefits from NCS of distal nerves. SN - 1872-8952 UR - https://www.unboundmedicine.com/medline/citation/28710923/Diagnostic_utility_of_distal_nerve_conduction_studies_and_sural_near_nerve_needle_recording_in_polyneuropathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1388-2457(17)30247-X DB - PRIME DP - Unbound Medicine ER -