Diagnostic markers of axonal degeneration and demyelination in sensory nerve conduction

Muscle Nerve. 2016 Jun;53(6):866-71. doi: 10.1002/mus.24950. Epub 2016 Feb 9.

Abstract

Introduction: The aim of this study was to formulate diagnostic hallmarks of axonal degeneration and demyelination in sensory nerve conduction studies (NCS).

Methods: We compared nerve conduction data obtained with surface electrode (SE) NCS and on-nerve needle (ONN) NCS in 50 cases of demyelination and 22 cases of axonal degeneration as assessed by sural nerve biopsy.

Results: The overall diagnostic sensitivities of sensory nerve conduction were 26% by SE-NCS and 69% by ONN-NCS. The most helpful marker for demyelination was negative-peak nerve conduction velocity (NP-NCV), using a 36% decrease from the means in both techniques. Dispersion was also helpful in identifying demyelination. Low amplitude and absence of compound nerve action potential were indicative of general pathology in SE-NCS but of axonal degeneration in ONN-NCS.

Conclusion: Although diagnostic sensitivity is low, NP-NCV and dispersion can be used for diagnosis of demyelination in sensory NCS. Muscle Nerve 53: 866-871, 2016.

Keywords: demyelination; diagnostic hallmark; nerve biopsy; on-nerve needle nerve conduction; sensory nerve conduction.

MeSH terms

  • Action Potentials / physiology
  • Biopsy
  • Chi-Square Distribution
  • Demyelinating Diseases / diagnosis*
  • Demyelinating Diseases / physiopathology*
  • Electrodes
  • Female
  • Humans
  • Male
  • Nerve Degeneration / diagnosis*
  • Nerve Degeneration / physiopathology*
  • Neural Conduction / physiology*
  • Reaction Time / physiology
  • Retrospective Studies
  • Skin Temperature / physiology
  • Sural Nerve / physiopathology*