Nerve Conduction Studies In Lower Limb Weakness
Nerve Conduction Studies In Lower Limb Weakness
Keywords:
Nerve conduction study, conduction block, distal symmetrical neuropathy, limb weaknessAbstract
Introduction: Nerve conduction studies (NCS) are an essential part of the work-up of peripheral neuropathies. NCS with EMG allows diagnostic classification, understanding and separation of different neuropathies. Symmetrical lower limb weakness of neurological origin often demands EDX study. Neuropathies may be mixed or motor or sensory. Further it may be either axonal or demyelinating. Aims and objectives: To assess nerve conduction studies in symmetrical lower limb weakness patients with peripheral neuropathies. To estimate prevalence of neuropathies in this cohort. Material methods: Forty cases and equal no of controls underwent NCV study. Tibial peroneal motor and sural sensory nerve conductions were done. Data was stored in excel sheet for analysis. Different NCV variables were compared between the groups. Unpaired t’test was used for comparison of variables. Level of significance was kept at p value <0.05. Results: It was observed that DML, CMAP/SNAP amplitude, and CV of study group were significantly different as compared to control group (p value <0.05). Neuropathy was present in 31 (77.5%) cases. 25 (80.65%) cases were axonal and 6 (19.35%) were demyelinating neuropathies. NCV was normal in 9 (22.5%) cases. Conclusion: NCV study proved an essential tool in diagnosis of neuropathies in lower limb weakness cases. Axonal neuropathies were more prevalent as compared to demyelinating one. Mixed neuropathies were more frequent than isolated motor or sensory neuropathies. Presence of conduction block suggests acquired demyelination. [Vijay v NJIRM 2016; 7(4): 56-60]
References
2. Jeffrey Cohen Camilo Fadul, Lawrence Jenkyn Thomas Ward. Evaluation of the Patient with Weakness. In: disorders of nervous system byReeves and Swenson. Online version of Dartmouth Medical school. 2008.
3. Moussouttas M, Chandy D, Dyro F. Fulminant acute inflammatory demyelinating polyradiculoneuropathy: case report and literature review. Neurocrit Care 2004;1(4):469-474.
4. Hund E. Critical illness polyneuropathy. Review.Curr Opin Neurol 2001;14:649-53.
5. Bolton CF. Neuromuscular manifestations of critical illness. Muscle Nerve 2005;32:140-63.
6. Preston DC, Shapiro BE. Electromyography and neuromuscular disorders: Approach to electrodiagnostic studies in the intensive care unit. Philadelphia: Elsevier; 2005:615-25.
7. Martel J, Mierau D, Donat J. Charcot-Marie-Tooth disease. J Manipulative Physiol Ther. 1995; 18(3):168-71.
8. Rubens O, Logina I, Kravale I, Eglîte M, Donaghy M. Peripheral neuropathy in chronic occupational inorganic lead exposure: a clinical and electrophysiological study. J Neurol Neurosurg Psychiatry. 2001; 71(2):200-4.
9. Al-Shekhlee A, Hachwi RN, Preston DC, Katirji B. New criteria for early electrodiagnosis of acute inflammatory demyelinating polyneuropathy. Muscle Nerve. 2005; 32(1):66-72.
10. Nagarajan V, Al-Shubaili A. Clinical and neurophysiological pattern of Guillain-Barré syndrome in Kuwait. Med Princ Pract. 2006;15(2):120-5.
11. Chen CC, Chiu PC, Shih CH, Hsieh KS. Proximal weakness of lower limbs as the sole presentation of hyperthyroidism: report of one case. Acta Paediatr Taiwan. 2005; 46(2):91-3.
12. Visser J, de Visser M, Van den Berg-Vos RM, Van den Berg LH, Wokke JH, de Jong JM, Franssen H. Interpretation of electrodiagnostic findings in sporadic progressive muscular atrophy. J Neurol. 2008;255(6):903-9.
13. Kakrani AL, Gokhale VS, Vohra KV, Chaudhary N. Clinical and nerve conduction study correlation in patients of diabetic neuropathy. J Assoc Physicians India. 2014; 62(1):24-7.
14. Grisold W, Berger O, Zifko U. Role of electrophysiology in diagnosis of polyneuropathies. Wien Med Wochenschr. 1998;148(1-2):19-24.
15. Franssen H, van den Bergh PY. Nerve conduction studies in polyneuropathy: practical physiology
and patterns of abnormality. Acta Neurol Belg. 2006 Jun;106(2):73-81.
