Premium
Prevalence of denervation in the intrinsic foot muscles in patients with distal predominantly small fiber neuropathy
Author(s) -
Parikh Prachi,
Polston David,
Li Yuebing
Publication year - 2020
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/mus.26829
Subject(s) - denervation , reinnervation , medicine , skin biopsy , biopsy , nerve fiber , polyneuropathy , surgery , anatomy
Background We aimed to evaluate the significance of electromyographic findings in the intrinsic foot muscles (IFMs) of patients with skin biopsy proven small fiber neuropathy (SFN). Methods This was a single‐center retrospective analysis of patients who underwent skin biopsy for intra‐epidermal nerve fiber density (IENFD) measurement and electrodiagnostic (EDX) study for evaluation of polyneuropathy. Results A total of 1416 patents with normal lower extremity EDX studies proximal to the foot were included. Active denervation was seen in 16.1% of IFMs in patients with skin biopsy proven SFN and 4.1% of patients without SFN ( P < .0001). Reinnervation changes without active denervation were observed in 30.4% of SFN patients and 23.8% of patients without SFN ( P = .01). IENFD was lower in SFN patients with active denervation in IFMs than without ( P < .0001). Conclusions Evaluation of active denervation in the IFMs can reveal large fiber dysfunction in SFN patients with otherwise normal routine EDX findings.