Acquired Neuropathies

Amato, Anthony A.; Dumitru, Daniel

doi:10.1016/b978-1-56053-433-4.50031-6

Cited by 15 publications

(9 citation statements)

References 1,254 publications

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“…Figure 14 shows the distribution of H reflex results (that may be normal, delayed, or absent) in confirmed, probable, and excluded CIDP. The association of Absent H reflex with confirmed CIDP is very strong (over 95%) and this seems to confirm the indication from literature (Lhotska et al, 2001;Amato and Dumitru, 2002;Hadden et al, 2006). But Absent H was also widely represented in excluded CIDP.…”

Section: Reverse Engineering Results -The Role Of H Reflexsupporting

confidence: 87%

A Knowledge-Based System for Evaluation of CIDP Diagnostic Criteria in a Database with 26,000 Nerve Conduction Studies: Computer-Aided Creation of Heuristic Rules and Discovery of New Diagnostic Criteria

Bonadonna

Killian

2015

Front. ICT

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This paper describes the implementation and the evaluation of 19 chronic inflammatory demyelinating polyneuropathy (CIDP) diagnostic criteria in a hospital information system (HIS) that contains more than 26,000 motor nerve conduction studies (MNCS), integrated with a knowledge-based system (KBS) that contains and applies neurological knowledge, including the CIDP criteria. The comparison, conducted on 3,750 manual reviewed cases, gave very different results in terms of sensibility and specificity with no one single criterion satisfying for both. Based on personal experience, variations of these CIDP criteria were tried, but the results were not improved. Then, a radically different approach was developed, programming the HIS-KBS to "discover" better criteria in order of their ability to comply with the manual review of cases. The result was a strong reduction of false positives with minimal loss of sensibility. By "reverse engineering" of the computer-generated criteria, it was possible to obtain some new interesting neurologic suggestions, such as the role of H reflex. In conclusion, four points appear of general interest: (1) a large HIS-KBS is fundamental for developing and testing diagnostic criteria and medical procedures, particularly when they are complex; (2) "computer-aided discovery" may create rules that allows the KBS to replicate the human expertise; (3) "reverse engineering" on computer-generated rules may suggest new physiopathological considerations; and (4) this methodology has general application to many other fields of medicine.

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Section: Reverse Engineering Results -The Role Of H Reflexsupporting

confidence: 87%

A Knowledge-Based System for Evaluation of CIDP Diagnostic Criteria in a Database with 26,000 Nerve Conduction Studies: Computer-Aided Creation of Heuristic Rules and Discovery of New Diagnostic Criteria

Bonadonna

Killian

2015

Front. ICT

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“…Although treatment with glucocorticoids, plasma exchange and IVIG alone or in combination with mycophenolate mofetil have been tried and suggested, the supporting evidence is anecdotal at best because none of these regimens have been studied in a controlled manner. There is also the possibility of spontaneous stabilization and resolution [ 14 , 25 ]. Chimeric monoclonal antibodies such as rituximab and infliximab have also been found to be useful [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Sensory neuronopathy complicating systemic lupus erythematosus: a case report

et al. 2014

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IntroductionSystemic lupus erythematosus is a multi-system connective tissue disorder. Peripheral neuropathy is a known and underestimated complication in systemic lupus erythematosus. Ganglionopathy manifests when neuronal cell bodies in the dorsal root ganglion are involved. Autoimmune disorders are a known etiology, with systemic lupus erythematosus being a rare cause.Case presentationA 32-year-old South Asian woman presented with oral ulceration involving her lips following initiation of treatment for a febrile illness associated with dysuria. She had a history of progressively worsening numbness over a period of 4 months involving both the upper and lower limbs symmetrically while sparing the trunk. Her vibration sense was impaired, and her reflexes were diminished. For the past 4 years, she had had a bilateral, symmetrical, non-deforming arthritis involving the upper and lower limbs. Her anti-nuclear antibody and anti-double-stranded deoxyribonucleic acid status were positive. Although her anti-Ro antibodies were positive, she did not have clinical features suggestive of Sjögren syndrome. Nerve conduction studies revealed sensory neuronopathy. A diagnosis of systemic lupus erythematosus complicated by sensory neuronopathy was made. Treatment with intravenous immunoglobulin resulted in clinical and electrophysiological improvement.ConclusionPeripheral neuropathy in systemic lupus erythematosus can, by itself, be a disabling feature. Nerve conduction studies should be considered when relevant. Neuropathy in systemic lupus erythematosus should be given greater recognition, and rarer forms of presentation should be entertained in the differential diagnosis when the clinical picture is atypical. Intravenous immunoglobulin may have role in treatment of sensory neuronopathy in systemic lupus erythematosus.

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“…Exclusion criteria were diabetes mellitus, physical examination findings indicative of peripheral neuropathy, a history of hip surgery, inguinal herniorrhaphy or surgery in the inguinal or the antero‐medial thigh region, a history of alcoholism, trauma to the inguinal region, or recent childbirth (less than 6 months). We also excluded people with sensory symptoms in the lower limbs or those being treated with potentially neurotoxic drugs …”

Section: Methodsmentioning

confidence: 99%

Medial femoral cutaneous nerve conduction study with distal recording: A novel technique

et al. 2020

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Background A new technique to obtain the sensory nerve action potential (SNAP) of the medial femoral cutaneous nerve is described. Methods SNAPs were recorded from 104 subjects with a bar recording electrode 10 cm proximal to the patella along an imaginary line drawn between the medial edge of the patella and the femoral pulse below the inguinal ligament. Stimulation was applied 14 cm proximal to the recording point. Results There were 104 healthy subjects. Onset latency of the SNAPs was 2.20 ± 0.16 ms (mean ± SD), peak latency was 2.70 ± 0.16 ms, peak‐to‐peak amplitude was 7.5 ± 3.0 μV, and conduction velocity was 51.5 ± 3.0 m/s. The side‐to‐side difference in the mean amplitude was 22.27 ± 13.6%. Conclusions This new technique is easy, reliable, and reproducible, and should prove useful for the evaluation of neuropathies of the medial femoral cutaneous nerve.

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Acquired Neuropathies

Cited by 15 publications

References 1,254 publications

A Knowledge-Based System for Evaluation of CIDP Diagnostic Criteria in a Database with 26,000 Nerve Conduction Studies: Computer-Aided Creation of Heuristic Rules and Discovery of New Diagnostic Criteria

A Knowledge-Based System for Evaluation of CIDP Diagnostic Criteria in a Database with 26,000 Nerve Conduction Studies: Computer-Aided Creation of Heuristic Rules and Discovery of New Diagnostic Criteria

Sensory neuronopathy complicating systemic lupus erythematosus: a case report

Medial femoral cutaneous nerve conduction study with distal recording: A novel technique

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