Pathophysiology inferred from electrodiagnostic nerve tests and classification of polyneuropathies. Suggested guidelines

Hatice Tankisi, Kirsten Pugdahl, Anders Fuglsang-Frederiksen, Birger Johnsen, Mamede De Carvalho, Peter R W Fawcett, Annick Labarre-Vila, Rocco Liguori, Wilfred A. Nix, Ian S. Schofield

Research output: Contribution to journalArticle

Abstract

Objective: To present criteria for pathophysiological interpretation of motor and sensory nerve conduction studies and for pathophysiological classification of polyneuropathies suggested by a group of European neurophysiologists. Methods: Since 1992 seven neurophysiologists from six European countries have collected random samples of their electrodiagnostic examinations for peer review medical audit in the ESTEEM (European Standardized Telematic tool to Evaluate Electrodiagnostic Methods) project. Based on existing criteria in the literature, the experience with a patient material of 572 peer reviewed electrodiagnostic examinations, and productive discussions between the physicians at workshops, the collaboration has produced a set of criteria now routinely used at the centres involved in the project. Results: The first part of the paper considers pathophysiology of individual nerve segments. For interpretation of motor and sensory nerve conduction studies, figures showing change in amplitude versus change in conduction velocity/distal latency and change in F-wave frequency versus change in F-wave latency are presented. The suggested boundaries delimit areas corresponding to normal, axonal, demyelinated, or neuropathic nerve segments. Criteria for motor conduction block in upper and lower extremities are schematically depicted using the parameters CMAP amplitude and CMAP duration. The second part of the paper suggests criteria for classification of polyneuropathies into axonal, demyelinating, or mixed using the above-mentioned criteria. Conclusions: The suggested criteria are developed during many years of collaboration of different centres and may be useful for standardization in clinical neurophysiology. Significance: Consistent interpretation of nerve conduction studies is an important step in optimising diagnosis and treatment of nerve disorders.

Original languageEnglish
Pages (from-to)1571-1580
Number of pages10
JournalClinical Neurophysiology
Volume116
Issue number7
DOIs
Publication statusPublished - Jul 2005

Keywords

  • Criteria for axonal loss
  • Criteria for demyelination
  • Nerve conduction studies
  • Pathophysiological states of nerves
  • Polyneuropathy classification

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Sensory Systems
  • Physiology (medical)

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    Tankisi, H., Pugdahl, K., Fuglsang-Frederiksen, A., Johnsen, B., De Carvalho, M., Fawcett, P. R. W., Labarre-Vila, A., Liguori, R., Nix, W. A., & Schofield, I. S. (2005). Pathophysiology inferred from electrodiagnostic nerve tests and classification of polyneuropathies. Suggested guidelines. Clinical Neurophysiology, 116(7), 1571-1580. https://doi.org/10.1016/j.clinph.2005.04.003