Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview
ABSTRACT Background: Polyneuropathies are characterized by a symmetrical impairment of the peripheral nervous system, resulting in sensory, motor and/or autonomic deficits. Due to the heterogeneity of causes, an etiological diagnosis for polyneuropathy is challenging. Objective: The aim of this study was to determine the main causes of polyneuropathy confirmed by electrodiagnostic (EDX) tests in a tertiary service and its neurophysiological aspects. Methods: This observational cross-sectional study from a neuromuscular disorders center included individuals whose electrodiagnostic tests performed between 2008 and 2017 confirmed a diagnosis of polyneuropathy. Through analysis of medical records, polyneuropathies were classified according to etiology and neurophysiological aspect. Results: Of the 380 included patients, 59.5% were male, with a median age of 43 years. The main etiologies were: inflammatory (23.7%), hereditary (18.9%), idiopathic (13.7%), multifactorial (11.1%), and diabetes (10.8%). The main electrophysiological patterns were axonal sensorimotor polyneuropathy (36.1%) and “demyelinating and axonal” sensorimotor polyneuropathy (27.9%). Axonal patterns showed greater etiological heterogeneity, with a predominance of idiopathic and multifactorial polyneuropathy, while demyelinating and “demyelinating and axonal” polyneuropathies had a significantly fewer etiologies, with a predominance of hereditary and inflammatory polyneuropathies. Conclusion: The main causes of polyneuropathy confirmed by EDX test in this study were those that presented a severe, atypical and/or rapidly progressing pattern. Other causes were hereditary and those that defy clinical reasoning, such as multiple risk factors; some polyneuropathies did not have a specific etiology. EDX tests are useful for etiological diagnosis of rare polyneuropathies, because neurophysiological patterns are correlated with specific etiologies.
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2022
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oai:scielo:S0004-282X20220003002702022-04-04Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overviewDucci,Renata Dal-PráTessaro,Camila LorenziniKay,Cláudia Suemi KamoiFustes,Otto Jesus HernandezWerneck,Lineu CesarLorenzoni,Paulo JoséScola,Rosana Herminia Polyneuropathies Epidemiology Diagnosis Electrodiagnosis ABSTRACT Background: Polyneuropathies are characterized by a symmetrical impairment of the peripheral nervous system, resulting in sensory, motor and/or autonomic deficits. Due to the heterogeneity of causes, an etiological diagnosis for polyneuropathy is challenging. Objective: The aim of this study was to determine the main causes of polyneuropathy confirmed by electrodiagnostic (EDX) tests in a tertiary service and its neurophysiological aspects. Methods: This observational cross-sectional study from a neuromuscular disorders center included individuals whose electrodiagnostic tests performed between 2008 and 2017 confirmed a diagnosis of polyneuropathy. Through analysis of medical records, polyneuropathies were classified according to etiology and neurophysiological aspect. Results: Of the 380 included patients, 59.5% were male, with a median age of 43 years. The main etiologies were: inflammatory (23.7%), hereditary (18.9%), idiopathic (13.7%), multifactorial (11.1%), and diabetes (10.8%). The main electrophysiological patterns were axonal sensorimotor polyneuropathy (36.1%) and “demyelinating and axonal” sensorimotor polyneuropathy (27.9%). Axonal patterns showed greater etiological heterogeneity, with a predominance of idiopathic and multifactorial polyneuropathy, while demyelinating and “demyelinating and axonal” polyneuropathies had a significantly fewer etiologies, with a predominance of hereditary and inflammatory polyneuropathies. Conclusion: The main causes of polyneuropathy confirmed by EDX test in this study were those that presented a severe, atypical and/or rapidly progressing pattern. Other causes were hereditary and those that defy clinical reasoning, such as multiple risk factors; some polyneuropathies did not have a specific etiology. EDX tests are useful for etiological diagnosis of rare polyneuropathies, because neurophysiological patterns are correlated with specific etiologies.info:eu-repo/semantics/openAccessAcademia Brasileira de Neurologia - ABNEUROArquivos de Neuro-Psiquiatria v.80 n.3 20222022-03-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2022000300270en10.1590/0004-282x-anp-2020-0561 |
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Ducci,Renata Dal-Prá Tessaro,Camila Lorenzini Kay,Cláudia Suemi Kamoi Fustes,Otto Jesus Hernandez Werneck,Lineu Cesar Lorenzoni,Paulo José Scola,Rosana Herminia |
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Ducci,Renata Dal-Prá Tessaro,Camila Lorenzini Kay,Cláudia Suemi Kamoi Fustes,Otto Jesus Hernandez Werneck,Lineu Cesar Lorenzoni,Paulo José Scola,Rosana Herminia Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview |
author_facet |
Ducci,Renata Dal-Prá Tessaro,Camila Lorenzini Kay,Cláudia Suemi Kamoi Fustes,Otto Jesus Hernandez Werneck,Lineu Cesar Lorenzoni,Paulo José Scola,Rosana Herminia |
author_sort |
Ducci,Renata Dal-Prá |
title |
Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview |
title_short |
Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview |
title_full |
Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview |
title_fullStr |
Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview |
title_full_unstemmed |
Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview |
title_sort |
peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview |
description |
ABSTRACT Background: Polyneuropathies are characterized by a symmetrical impairment of the peripheral nervous system, resulting in sensory, motor and/or autonomic deficits. Due to the heterogeneity of causes, an etiological diagnosis for polyneuropathy is challenging. Objective: The aim of this study was to determine the main causes of polyneuropathy confirmed by electrodiagnostic (EDX) tests in a tertiary service and its neurophysiological aspects. Methods: This observational cross-sectional study from a neuromuscular disorders center included individuals whose electrodiagnostic tests performed between 2008 and 2017 confirmed a diagnosis of polyneuropathy. Through analysis of medical records, polyneuropathies were classified according to etiology and neurophysiological aspect. Results: Of the 380 included patients, 59.5% were male, with a median age of 43 years. The main etiologies were: inflammatory (23.7%), hereditary (18.9%), idiopathic (13.7%), multifactorial (11.1%), and diabetes (10.8%). The main electrophysiological patterns were axonal sensorimotor polyneuropathy (36.1%) and “demyelinating and axonal” sensorimotor polyneuropathy (27.9%). Axonal patterns showed greater etiological heterogeneity, with a predominance of idiopathic and multifactorial polyneuropathy, while demyelinating and “demyelinating and axonal” polyneuropathies had a significantly fewer etiologies, with a predominance of hereditary and inflammatory polyneuropathies. Conclusion: The main causes of polyneuropathy confirmed by EDX test in this study were those that presented a severe, atypical and/or rapidly progressing pattern. Other causes were hereditary and those that defy clinical reasoning, such as multiple risk factors; some polyneuropathies did not have a specific etiology. EDX tests are useful for etiological diagnosis of rare polyneuropathies, because neurophysiological patterns are correlated with specific etiologies. |
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Academia Brasileira de Neurologia - ABNEURO |
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2022 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2022000300270 |
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