Devic Perrine, Petiot Philippe, Mauguiere François
Hospices Civils de Lyon, Université Lyon I, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie Fonctionnelle et d'Epileptologie, 59 Boulevard Pinel, 69003, Lyon, France.
Hospices Civils de Lyon, Université Lyon I, Hôpital de la Croix-Rousse, Centre de Référence Maladies Neuro-musculaires Rares, Lyon, France.
Muscle Nerve. 2016 Jan;53(1):78-83. doi: 10.1002/mus.24693. Epub 2015 Nov 26.
Diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) remains uncertain when nerve conduction studies (NCS) fail to show demyelination.
We conducted a retrospective study of patients who presented with clinical criteria of CIDP in whom electrodiagnostic (EDx) criteria of definite or probable CIDP were missing [axonal sensorimotor neuropathy (n = 23), normal EDx with pure sensory presentation (n = 3)]. All patients received immunomodulatory treatment. Twenty-six patients were evaluated with somatosensory evoked potentials (SSEPs), MRI of spinal roots, cerebrospinal fluid analysis, and/or nerve biopsy. Diagnosis of CIDP was considered to be confirmed in patients who responded to immunotherapy.
Twenty-two of 26 patients (85%) had SSEPs reflecting abnormal proximal conduction in sensory fibers, including 14 who had only clinical and SSEP data in favor of CIDP. SSEPs were abnormal in 16 of 20 responders (80%) to immunotherapy.
SSEP recording contributes to the diagnosis of CIDP when nerve conduction studies fail to detect peripheral demyelination.
当神经传导研究（NCS）未能显示脱髓鞘时，慢性炎症性脱髓鞘性多发性神经病（CIDP）的诊断仍不明确。
我们对符合CIDP临床标准但缺乏明确或可能CIDP的电诊断（EDx）标准的患者进行了一项回顾性研究[轴索性感觉运动神经病（n = 23），纯感觉表现且EDx正常（n = 3）]。所有患者均接受免疫调节治疗。26例患者接受了体感诱发电位（SSEP）、脊神经根MRI、脑脊液分析和/或神经活检评估。对免疫治疗有反应的患者被认为确诊为CIDP。
26例患者中有22例（85%）的SSEP显示感觉纤维近端传导异常，其中14例仅有临床和SSEP数据支持CIDP。20例免疫治疗有反应的患者中有16例（80%）SSEP异常。
当神经传导研究未能检测到周围脱髓鞘时，SSEP记录有助于CIDP的诊断。
