Do A‐waves help predict intravenous immunoglobulin response in multifocal motor neuropathy without block?

Lange, Dale J.; Nijjar, Rajwinder; Voustianiouk, Andrei; Seidel, Gregory; Panchal, Janki; Wang, Annabel K.

doi:10.1002/mus.21914

Cited by 2 publications

(1 citation statement)

References 43 publications

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“…The reason for this is unclear but raises the question of subtle underlying pathologic condition. However, our study was consistent with the reports in the medical literature that A-waves are more frequent in patients with various neurologic conditions, including demyelinating neuropathies, 8,15,16 axonal neuropathies, 14,17 focal mononeuropathies, 6,10 radiculopathies, 6 and motor neuron diseases. 13 In our study, the most significant associations were in those with demyelinating neuropathies or entrapment neuropathies, although the presence or absence of A-waves did not alter the diagnosis or conclusions.…”

Section: Discussionsupporting

confidence: 93%

The Presence and Significance of A-Waves—A Retrospective Review of 679 Patients

Zhang

Roberts

2020

Journal of Clinical Neurophysiology

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Purpose: A-waves are late responses that have been reported in healthy individuals and patients with neurologic conditions. The mechanism(s) responsible for their generation and their clinical significance are not fully understood. The aim was to better characterize A-waves.Methods: A retrospective study was conducted in a high-volume Neurophysiology Department in a tertiary hospital in Melbourne, Australia. Consecutive neurophysiological tests including F-wave studies performed between July 2017 and September 2018 were reviewed to identify A-waves. Patients' characteristics and neurophysiological diagnoses were recorded.Results: A total of 679 patients were included in the analysis and a total of 2,730 nerves were studied. A-waves were most commonly found in tibial nerves, followed by peroneal, median, and ulnar nerves. A-waves were seen in 39.4% of individuals with otherwise normal nerve conduction studies and 39.1% of individuals with entrapment neuropathy. They were most seen in demyelinating neuropathy (85.7%), followed by mixed neuropathy (73.3%), anterior horn cell disease (66.7%), axonal neuropathy (61.2%), and radiculopathy (53.1%). Most patients with demyelinating neuropathy had multiple A-waves (61.9%), but these were also seen in 15.2% of individuals with otherwise normal nerve conduction studies and in 40% of those with other neurologic conditions. A-waves were more often seen in individuals older than 60 years.Conclusions: A-waves are commonly seen in symptomatic individuals with otherwise normal nerve conduction studies and individuals with various neurologic conditions but are more commonly found in nerves with otherwise abnormal electrophysiological testing. A-waves are most seen in tibial nerves. Multiple A-waves were more commonly seen in demyelinating neuropathy than other conditions.

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