Abstract Details

Title Undiagnosing CIDP

Topic Clinical Neurophysiology

Presentation(s) P02 - (-)

Poster/Presentation
Number 231

Objective

Background BACKGROUND: EDX criteria for CIDP require the demonstration of demyelinating abnormalities in multiple nerves. The demyelinating findings, however, may change over time due to progression or improvement of the neuropathy.

Design/Methods DESIGN/METHODS: We retrospectively reviewed EDX studies at our Neuropathy Center and identified 832 studies from 638 patients that exhibited demyelinating abnormalities. Of these, 125 patients had more than one study. EFNS/PNS guidelines, requiring 2 or more nerves to exhibit demyelinating abnormalities, were used as EDX criteria for CIDP.

Results RESULTS: Of the 125 patients with demyelinating EDX abnormalities who had follow-up studies, 43 had a decrease in the number of demyelinating findings over an average period 13.06 months. Distal latencies were improved in 14 (32.5%), conduction velocities in 20 (46.5%), CMAP durations in 18 (41.9%), and F responses in 6 (13.9%). Four (9.3%) patients had a decrease in the number of demyelinating findings due to loss of responses on subsequent study. Motor amplitudes were unchanged in nerves with improved conductions. In 18 of the 43 (41.9%) who fulfilled EFNS/PNS EDX criteria for CIDP, follow-up studies no longer met the EDX criteria, as the number of nerves with demyelinating abnormalities decreased from ?2 to 0 or 1.

Conclusions CONCLUSIONS: The number of demyelinating EDX abnormalities can decrease over time due to progression or improvement of the neuropathy. EDX studies at follow-up or at one time point may fail to confirm or identify the diagnosis of CIDP.

Authors/Disclosures
Mary Vo, MD (Weill Cornell Medical College) PRESENTER	Dr. Vo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Vo has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Phillips and Paolicchi.
	No disclosure on file
Russell L. Chin, MD	No disclosure on file
Bridget T. Carey, MD	No disclosure on file
Norman Latov, MD, PhD (Weill Cornell Medical College)	Dr. Latov has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Polyneuron. Dr. Latov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Therapath LLC. Dr. Latov has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Mcaloon & Freeman, PC. Dr. Latov has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Conway Homer PC. Dr. Latov has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Sylvia Chin-Kaplan, LLC. The institution of Dr. Latov has received research support from Takeda. Dr. Latov has received publishing royalties from a publication relating to health care.
Jennifer A. Langsdorf, MD	Dr. Langsdorf has nothing to disclose.
Michael S. Okun, MD, FAAN (University of Florida)	Dr. Okun has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Okun has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Parkinson's Foundation. Dr. Okun has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Okun has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Journal Watch. The institution of Dr. Okun has received research support from NIH. The institution of Dr. Okun has received research support from Parkinson's Foundation. The institution of Dr. Okun has received research support from Tourette Association of America. The institution of Dr. Okun has received research support from Michael J Fox. Dr. Okun has received publishing royalties from a publication relating to health care.

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