Acta Medica Iranica 2017. 55(8):496-501.

Peripheral Neuropathy in Multiple Sclerosis: An Electrophysiologic Study in Iranian Patients
Mohammad Reza Emad, Leila Zeinali, Alireza Nikseresht, Mahshid Naseri, Hajar Karimian

Abstract


Multiple sclerosis (MS) is the most common cause of disability after trauma in young adults in Northern Hemisphere; it imposes a major burden on the affected young people. A significant association between MS and demyelinating peripheral neuropathy which might be due to common pathogenesis for the central and peripheral nerves demyelination has been reported in several studies. We aimed to assess if there is any peripheral nervous system involvement in a sample of Iranian MS population. Extensive nerve conduction studies (NCS) were conducted in 20 MS patients according to McDonald criteria, and 20 age and gender matched healthy appearing controls. The F-wave ratio was calculated through placing the minimum amount of F-wave proximal latency after 10 stimuli and median or tibial nerves compound motor action potential (CMAP) proximal latency in the corresponding formula. Data were compared between groups. Finally, we found the significantly lower median and tibial nerves conduction velocities (NCV) in MS patients than healthy controls (P=0.008 and 0.003 respectively, Independent Samples t-test). Also, tibial NCV had a significant statistical correlation with Kurtzke’s expanded disability scale score (EDSS) as patients with higher EDSS had lower tibial NCV (Pearson's correlation coefficient, r2=0.8). No statistical relationship was found between MS subtypes and NCS parameters. Although we found some electrodiagnostic abnormalities in Iranian MS patients in comparison to the healthy participants, these differences were small and inconclusive. More extensive well-designed electrodiagnostic studies for evaluation of peripheral nervous system involvement and its probable pattern in these patients seems to be needed.


Keywords


Multiple sclerosis; Electro-diagnosis; Peripheral nervous system

Full Text:

PDF

References


Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69:292-302. doi: 10.1002/ana.22366. PubMed PMID: 21387374. Pubmed Central PMCID: 3084507.

Pugliatti M, Rosati G, Carton H, Riise T, Drulovic J, Vecsei L, et al. The epidemiology of multiple sclerosis in Europe. Eur J Neurol. 2006;13:700-22. PubMed PMID: 16834700.

Wei FC. Multiple sclerosis. Biomed J. 2014;37:33. doi: 10.4103/2319-4170.130317. PubMed PMID: 24732656.

Pollock M, Calder C, Allpress S. Peripheral nerve abnormality in multiple sclerosis. Ann Neurol. 1977;2:41-8. PubMed PMID: 900906.

Di Trapani G, Carnevale A, Cioffi RP, Massaro AR, Profice P. Multiple sclerosis associated with peripheral demyelinating neuropathy. Clin Neuropathol. 1996;15:135-8. PubMed PMID: 8793246.

Kwon JY, Kim JY, Jeong JH, Park KD. Multiple sclerosis and peripheral multifocal demyelinating neuropathies occurring in a same patient. J Clin Neurol. 2008;4:51-7. doi: 10.3988/jcn.2008.4.1.51. PubMed PMID: 19513326. Pubmed Central PMCID: 2686880.

Miles E. Drake J. Peripheral Neuropathy in Multiple Sclerosis. J Natl Med Assoc. 1987 1987;79:672-3. Pubmed Central PMCID: PMC2625532.

Mills KR, Murray NM. Neurophysiological evaluation of associated demyelinating peripheral neuropathy and multiple sclerosis: a case report. J Neurol Neurosurg Psychiatry. 1986;49:320-3. PubMed PMID: 3007677. Pubmed Central PMCID: 1028734.

Misawa S, Kuwabara S, Mori M, Hayakawa S, Sawai S, Hattori T. Peripheral nerve demyelination in multiple sclerosis. Clin Neurophysiol. 2008;119:1829-33. doi: 10.1016/j.clinph.2008.04.010. PubMed PMID: 18495530.

Dumitru D, Zwarts M, Amato A. Special Nerve Conduction Techniques. In Dumitru D, Zwarts M, editors:Electrodiagnostic Medicine. 2nd ed. Philadelphia; Hanley & Belfus, Inc.; 2002. p. 242-3.

Anlar O, Tombul T, Kisli M. Peripheral sensory and motor abnormalities in patients with multiple sclerosis. Electromyogr Clin Neurophysiol. 2003;43:349-51. PubMed PMID: 14535047.

Pogorzelski R, Baniukiewicz E, Drozdowski W. [Subclinical lesions of peripheral nervous system in multiple sclerosis patients]. Neurol Neurochir Pol. 2004;38:257-64. PubMed PMID: 15383952.

Gartzen K, Katzarava Z, Diener HC, Putzki N. Peripheral nervous system involvement in multiple sclerosis. Eur J Neurol. 2011;18:789-91. doi: 10.1111/j.1468-1331.2010.03149.x. PubMed PMID: 20629712.

Sarova-Pinhas I, Achiron A, Gilad R, Lampl Y. Peripheral neuropathy in multiple sclerosis: a clinical and electrophysiologic study. Acta Neurol Scand. 1995;91:234-8. PubMed PMID: 7625146.

Shefner JM, Carter JL, Krarup C. Peripheral sensory abnormalities in patients with multiple sclerosis. Muscle Nerve. 1992;15:73-6. PubMed PMID: 1732765.

Ayromlou H, Mohammad-Khanli H, Yazdchi-Marandi M, Rikhtegar R, Zarrintan S, Golzari SE, et al. Electrodiagnostic evaluation of peripheral nervous system changes in patients with multiple sclerosis. Malays J Med Sci. 2013;20:32-8. PubMed PMID: 24043994. Pubmed Central PMCID: 3773350.

Argyriou AA, Karanasios P, Makridou A, Makris N. F-wave characteristics as surrogate markers of spasticity in patients with secondary progressive multiple sclerosis. J Clin Neurophysiol. 2010;27:120-5. doi: 10.1097/WNP.0b013e3181d64c94. PubMed PMID: 20505376.

Adams RD, Kubik CS. The morbid anatomy of the demyelinative disease. Am J Med. 1952;12 :510-46. PubMed PMID: 14933429.


Refbacks

  • There are currently no refbacks.


Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.