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Impact of plasma exchange on indices of demyelination in chronic inflammatory demyelinating polyradiculoneuropathy
Author(s) -
Ashworth Nigel L.,
Zochodne Douglas W.,
Hahn Angelika F.,
Pillay Neelan,
Chalk Colin,
Benstead Timothy,
Bril Vera,
Feasby Thomas E.,
Bolton Charles F.
Publication year - 2000
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/(sici)1097-4598(200002)23:2<206::aid-mus10>3.0.co;2-k
Subject(s) - medicine , f wave , elbow , polyradiculoneuropathy , ulnar nerve , compound muscle action potential , peripheral , chronic inflammatory demyelinating polyneuropathy , rheumatoid arthritis , nerve conduction velocity , cardiology , surgery , anatomy , electrophysiology , guillain barre syndrome , pediatrics , antibody , immunology
We studied the impact of plasma exchange (PE) on indices of primary demyelination in patients of the Canadian multicenter trial of PE in chronic inflammatory demyelinating polyneuropathy (CIDP). Individual motor nerves (median, ulnar, peroneal, tibial) were studied: distal motor latencies (DMLs), proximal and distal compound muscle action potential (M‐wave) amplitudes, negative peak areas and durations, and motor conduction velocities (CVs). Proximal M‐wave amplitudes in individual motor territories, particularly in the ulnar nerve (from below elbow, above elbow, and axillary stimulating sites) demonstrated significant improvement with PE, but not sham exchange. Proximal ulnar M‐wave areas also had significant improvement with PE. Trends toward improvement of individual nerve motor CVs, M‐wave durations, and DMLs did not achieve statistical significance. Proximal M‐wave amplitudes, particularly in the ulnar motor territory, and proximal M‐wave areas (providing a measure of conduction block) were the most sensitive indices of improvement conferred by PE in CIDP. In individual patients, these indices may help judge the efficacy of therapy. © 2000 John Wiley & Sons, Inc. Muscle Nerve 23: 206–210, 2000.