Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Mar;80(3):270-279.
doi: 10.1590/0004-282X-ANP-2020-0561.

Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview

Renata Dal-Prá Ducci  1 , Camila Lorenzini Tessaro  2 , Cláudia Suemi Kamoi Kay  1 , Otto Jesus Hernandez Fustes  1 , Lineu Cesar Werneck  1 , Paulo José Lorenzoni  1 , Rosana Herminia Scola  1
Affiliations
Observational Study

Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview

Renata Dal-Prá Ducci et al. Arq Neuropsiquiatr. 2022 Mar.

Abstract
in English, Portuguese

Background: Polyneuropathies are characterized by a symmetrical impairment of the peripheral nervous system, resulting in sensory, motor and/or autonomic deficits. Due to the heterogeneity of causes, an etiological diagnosis for polyneuropathy is challenging.

Objective: The aim of this study was to determine the main causes of polyneuropathy confirmed by electrodiagnostic (EDX) tests in a tertiary service and its neurophysiological aspects.

Methods: This observational cross-sectional study from a neuromuscular disorders center included individuals whose electrodiagnostic tests performed between 2008 and 2017 confirmed a diagnosis of polyneuropathy. Through analysis of medical records, polyneuropathies were classified according to etiology and neurophysiological aspect.

Results: Of the 380 included patients, 59.5% were male, with a median age of 43 years. The main etiologies were: inflammatory (23.7%), hereditary (18.9%), idiopathic (13.7%), multifactorial (11.1%), and diabetes (10.8%). The main electrophysiological patterns were axonal sensorimotor polyneuropathy (36.1%) and "demyelinating and axonal" sensorimotor polyneuropathy (27.9%). Axonal patterns showed greater etiological heterogeneity, with a predominance of idiopathic and multifactorial polyneuropathy, while demyelinating and "demyelinating and axonal" polyneuropathies had a significantly fewer etiologies, with a predominance of hereditary and inflammatory polyneuropathies.

Conclusion: The main causes of polyneuropathy confirmed by EDX test in this study were those that presented a severe, atypical and/or rapidly progressing pattern. Other causes were hereditary and those that defy clinical reasoning, such as multiple risk factors; some polyneuropathies did not have a specific etiology. EDX tests are useful for etiological diagnosis of rare polyneuropathies, because neurophysiological patterns are correlated with specific etiologies.

Antecedentes:: As polineuropatias caracterizam-se por um acometimento simétrico do sistema nervoso periférico, resultando em alterações sensitivas, motoras e/ou autonômicas. Devido à heterogeneidade de causas, estabelecer um diagnóstico etiológico para polineuropatia é desafiador.

Objetivo:: O objetivo desse estudo foi determinar as principais causas de polineuropatia confirmada pela eletroneuromiografia em um serviço terciário e seus aspectos neurofisiológicos.

Métodos:: Esse estudo transversal observacional de um centro de doenças neuromusculares incluiu indivíduos cuja eletroneuromiografia, realizada entre 2008 e 2017, estabeleceu o diagnóstico de polineuropatia. Através da análise dos prontuários, as polineuropatias foram classificadas de acordo com a etiologia e aspecto neurofisiológico.

Resultados:: Dos 380 pacientes incluídos, 59,5% eram homens, com uma mediana de idade de 43 anos. As principais etiologias foram: imunomediada (23,7%), hereditária (18,9%), idiopática (13,7%), multifatorial (11,1%) e diabetes (10,8%). Os principais padrões neurofisiológicos foram polineuropatia axonal sensitivo-motora (36,1%) e polineuropatia mista sensitivo-motora (27,9%). Os padrões axonais demonstraram maior heterogeneidade etiológica, com um predomínio das polineuropatias idiopática e multifatorial, enquanto os padrões desmielinizantes e mistos apresentaram uma significativa restrição de etiologias, com predomínio das polineuropatias hereditária e imunomediada.

Conclusão:: As principais causas de polineuropatia confirmadas pela eletroneuromiografia nesse estudo foram aquelas que apresentaram um padrão de acometimento grave, atípico e/ou rapidamente progressivo, além das polineuropatias hereditárias e daquelas que desafiam o raciocínio clínico, caracterizadas pela presença múltiplos fatores de risco ou pela ausência de uma etiologia. A eletroneuromiografia é útil para o diagnóstico etiológico de polineuropatias raras, já que os padrões neurofisiológicos se correlacionam com etiologias específicas.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: There is no conflict of interest to declare.

Figures

Figure 1.
Figure 1.. Flow chart of the study methodology.
Figure 2.
Figure 2.. Flow chart of polyneuropathies epidemiological profile according to neurophysiological aspects.
Figure 3.
Figure 3.. Distribution of different polyneuropathies according to the neurophysiological study.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Hanewinckel R, van Oijen M, Ikram MA, van Doorn PA. The epidemiology and risk factors of chronic polyneuropathy. Eur J Epidemiol. 2016;31(1):5–20. doi: 10.1007/s10654-015-0094-6. - DOI - PMC - PubMed
    1. Pasnoor M, Nascimento OJM, Trivedi J, Wolfe GI, Nations S, Herbelin L, et al. North America and South America (NA-SA) neuropathy project. Int J Neurosci. 2013;123(8):563–567. doi: 10.3109/00207454.2013.782026. - DOI - PubMed
    1. Felix EPV, Oliveira A de SB. Guidelines for the diagnosis of neuropathies in a Reference Center for Neuromuscular diseases. Rev Neurocienc. 2010;18(1):74–80.
    1. England JD, Asbury AK. Peripheral neuropathy. Lancet. 2004;363(9427):2151–2161. doi: 10.1016/S0140-6736(04)16508-2. - DOI - PubMed
    1. Watson JC, Dyck PJB. Peripheral neuropathy: a practical approach to diagnosis and symptom management. Mayo Clin Proc. 2015;90(7):P940–P951. doi: 10.1016/j.mayocp.2015.05.004. - DOI - PubMed

Publication types