Neuromuscular Clinic, Department of Neurology, University Hospitals of Leicester, Leicester, United Kingdom.
Clin Neurophysiol. 2013 Jan;124(1):171-5. doi: 10.1016/j.clinph.2012.05.019. Epub 2012 Jun 27.
To ascertain the practical electrodiagnostic value of F-waves in chronic inflammatory demyelinating polyneuropathy (CIDP).
We evaluated the diagnostic utility of F-waves in 18 prospectively-recruited patients with typical CIDP. Minimum/maximum/mean F-wave latencies, F-wave chronodispersion and F-wave persistence, were determined in median/ulnar/fibular/tibial nerves in patients and compared to controls with axonal neuropathy.
All latencies were significantly more delayed in CIDP patients. F-wave chronodispersion was significantly greater in median and ulnar nerves and F-wave persistence significantly more reduced in tibial nerves in CIDP patients. Use of these supplementary F-wave parameters was of value in identifying CIDP nerves. However F-wave studies were only of additional benefit to other demyelinating parameters in about 15% of all studied CIDP nerves.
F-waves may be diagnostically helpful in CIDP in a minority of nerves without other nerve conduction abnormalities. Analysis of F-wave chronodispersion in upper limb nerves and possibly of F-wave persistence in tibial nerves, may add value to basic minimum F-wave latency studies.
These results suggest F-wave analysis may not need to be systematic, for all nerves, in patients with suspected CIDP, especially those intolerant to electrical stimulation. Chronodispersion and persistence may be helpful parameters to consider in addition to minimum latency.
确定 F 波在慢性炎症性脱髓鞘性多发性神经病（CIDP）中的实际电诊断价值。
我们评估了 18 例前瞻性招募的典型 CIDP 患者中 F 波的诊断效用。在患者和伴有轴索性神经病的对照组中，确定正中神经/尺神经/腓总神经/胫神经的最小/最大/平均 F 波潜伏期、F 波时程离散度和 F 波持续时间。
CIDP 患者的所有潜伏期均显著延迟。CIDP 患者的正中神经和尺神经的 F 波时程离散度显著增加，而 F 波持续时间在胫神经中显著减少。这些补充 F 波参数的使用有助于识别 CIDP 神经。然而，在所有研究的 CIDP 神经中，F 波研究仅对其他脱髓鞘参数有额外益处的约 15%。
在没有其他神经传导异常的少数神经中，F 波可能对 CIDP 具有诊断帮助。在上肢神经中分析 F 波时程离散度，可能有助于 F 波持续时间在胫神经中的分析，这可能对基本的最小 F 波潜伏期研究有价值。
这些结果表明，在疑似 CIDP 的患者中，特别是在对电刺激不耐受的患者中，F 波分析可能不需要对所有神经进行系统分析。时程离散度和持续时间可能是除最小潜伏期外需要考虑的有用参数。
