Blink R1 latency utility in diagnosis and treatment assessment of polyradiculoneuropathy‐organomegaly‐endocrinopathy‐monoclonal protein‐skin changes and chronic inflammatory demyelinating polyradiculoneuropathy |
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Authors: | Wei Wang MD William J Litchy MD Michelle L Mauermann MD P James B Dyck MD Angela Dispenzieri MD Jay Mandrekar PhD Peter J Dyck MD Christopher J Klein MD |
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Institution: | 1. Department of Neurology, Mayo Clinic, 200 First Street, SW, Rochester, Minnesota, USA;2. Department of Neurology, China‐Japan Friendship Hospital, Beijing, China;3. Department of Hematology, Mayo Clinic, Rochester, Minnesota, USA;4. Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA |
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Abstract: | Introduction: In polyradiculoneuropathy‐organomegaly‐endocrinopathy‐monoclonal protein‐skin changes (POEMS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), limb nerve conduction studies (NCSs) are limited in identifying demyelination and in detecting treatment effects in severely affected patients. Blink R1 latency may improve these assessments. Methods: POEMS and CIDP patients who had undergone NCS and blink reflex were identified. Correlations among R1 latency, limb NCS, and neuropathy impairment scores (NIS) were compared. Results: Among 182 patients (124 POEMS, 58 CIDP) who were identified, R1 prolongation (>13 ms) occurred in 64.3% (65.3% POEMS, 62.1% CIDP). R1 prolongation correlated with more severely affected NCS in both POEMS (ulnar CMAP 2.6 mV vs. 4.5 mV, P = 0.001) and CIDP (2.0 mV vs. 6.1 mV, P < 0.001). In severely affected patients (ulnar CMAP ≤0.5 mV 10%:18/182]), R1 (>13 ms) helped establish demyelination. In 31 patients (16 POEMS, 15 CIDP), the R1 latency changes were concordant with NIS changes in 94% of patients with POEMS and 60% of patients with CIDP. Discussion: Blink R1 latencies are valuable in defining demyelination and detecting improvement in severely affected POEMS and CIDP patients. Muscle Nerve 57 : E8–E13, 2018 |
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Keywords: | blink reflex CIDP nerve conduction study neuropathy POEMS |
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