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Partial Conduction Block as an Early Nerve Conduction Finding in Neurolymphomatosis.

ABSTRACT: BACKGROUND AND PURPOSE:Neurolymphomatosis is a rare manifestation of hematological malignancy and is characterized by direct infiltration of the peripheral nervous system. The objective of this study was to identify the clinical and electrophysiological features of neurolymphomatosis. METHODS:We retrospectively analyzed the medical records of 13 patients with neurolymphomatosis. Seven (54%) of the patients were men, and the median age at symptom onset was 60.0 years. RESULTS:The most common type of underlying malignancy was diffuse large B-cell lymphoma (69%). Twelve patients had painful asymmetric neuropathies. The median survival time after diagnosis was 7 months, and 12 patients died during the study period. Thirty-eight motor nerve conduction studies (NCSs) were performed in the affected nerves. Ten and 28 motor nerves were classified into the conduction-block and simple-axon-degeneration groups, respectively. The median time interval between symptom onset and the NCS was significantly shorter in the conduction-block group than in the simple-axon-degeneration group (p=0.032). However, no significant differences in the motor nerve conduction velocities, terminal latencies, and distal compound muscle action potential amplitudes were identified between the conduction-block and simple-axon-degeneration groups. The conduction-block group showed excessive temporal dispersion in only five of the ten NCSs (50%). Follow-up NCSs revealed that partial conduction blocks had changed into axonal degeneration patterns. CONCLUSIONS:This is the first study to analyze the electrophysiological features of patients with neurolymphomatosis. Our findings showed that a partial conduction block is not rare and is an early nerve conduction abnormality in neurolymphomatosis.

SUBMITTER: Park HJ

PROVIDER: S-EPMC5765259 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Partial Conduction Block as an Early Nerve Conduction Finding in Neurolymphomatosis.

Park Hyung Jun HJ Shin Ha Young HY Kim Se Hoon SH Jeong Ha Neul HN Choi Young Chul YC Suh Bum Chun BC Park Kee Duk KD Kim Seung Min SM

Journal of clinical neurology (Seoul, Korea) 20180101 1

<h4>Background and purpose</h4>Neurolymphomatosis is a rare manifestation of hematological malignancy and is characterized by direct infiltration of the peripheral nervous system. The objective of this study was to identify the clinical and electrophysiological features of neurolymphomatosis.<h4>Methods</h4>We retrospectively analyzed the medical records of 13 patients with neurolymphomatosis. Seven (54%) of the patients were men, and the median age at symptom onset was 60.0 years.<h4>Results</h ...[more]

PMID: 29629543

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Project description:OBJECTIVE: To quantify nerve conduction study (NCS) reproducibility utilizing an automated NCS system (NC-stat, NeuroMetrix, Inc.). METHOD: Healthy volunteers without neuropathic symptoms participated in the study. Their median, ulnar, peroneal, and tibial nerves were tested twice (7 days apart) by the same technician with an NC-stat instrument. Pre-fabricated electrode arrays specific to each nerve were used. Both motor responses (compound motor action potential [CMAP] and F-waves - all nerves) and sensory responses (sensory nerve action potentials [SNAP] - median and ulnar nerves only) were recorded following supramaximal stimuli. Automated algorithms determined all NCS parameters: distal motor latency (DML), mean F-wave latency (FWL), distal sensory latency (DSL), CMAP amplitude, and SNAP amplitude. Latency was adjusted for skin temperature deviation from reference. Pearson correlation coefficient (CC), intraclass correlation coefficient (ICC), coefficient of variance (CoV), and relative intertrial variation (RIV) were calculated. RESULTS: Fifteen subjects participated in either upper or lower extremity studies with nine participating in both. With the exception of CMAP amplitude, all parameters had CoV less than 0.06. Upper extremity amplitude parameters had CCs greater than 0.85. CCs for latencies were greater than 0.80 except for the median nerve FWL (CC = 0.69). For lower extremity nerves, ICCs were highest for mean FWL (>0.90), followed by DML (>0.82) and then CMAP (peroneal 0.33, tibial 0.73). The 10th to 90th RIV percentiles were bounded by +/-7% for F-wave latencies; +/- 9% for all DSLs; and +/- 11% for DML (except peroneal at 15%). CONCLUSIONS: The reproducibility of NCS parameters obtained with an automated NCS instrument compared favorably with traditional electromyography laboratories. F-wave latencies had the highest repeatability, followed by DML, DSL, SNAP and CMAP amplitude. Given their high reproducibility, automated NCS instrument may encourage wider utilization of NCS in clinical and research applications.

Dataset Information

Partial Conduction Block as an Early Nerve Conduction Finding in Neurolymphomatosis.

Publications

Partial Conduction Block as an Early Nerve Conduction Finding in Neurolymphomatosis.

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