Temporal dispersion in demyelination of POEMS syndrome and Castleman disease
Objective: We detailed the electrophysiological patterns of peripheral nerve temporal dispersion across spectrum of POEMS syndrome and Castleman disease (CD). Methods: Compound muscle action potentials (CMAP) duration of 3 patients with POEMS syndrome and 2 with hyaline vascular type CD without clon...
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doaj-59f57725fb1e49be8181334d15e63df02020-12-21T04:47:48ZengElsevierClinical Neurophysiology Practice2467-981X2020-01-015112117Temporal dispersion in demyelination of POEMS syndrome and Castleman diseaseYue Hui Lau0Hazfadzila Mohd Unit1Lay Peng Lee2Weng Khean Loh3Fu Liong Hiew4Department of Neurology, Kuala Lumpur Hospital, Jalan Pahang, 50586, Wilayah Persekutuan, Kuala Lumpur, MalaysiaDepartment of Neurology, Kuala Lumpur Hospital, Jalan Pahang, 50586, Wilayah Persekutuan, Kuala Lumpur, MalaysiaDepartment of Medicine, Sibu Hospital, KM 5 1/2, Jalan Ulu Oya, 96000 Sarawak, MalaysiaHaematology Unit, Department of Medicine, Kuala Lumpur Hospital, Jalan Pahang, 50586, Wilayah Persekutuan, Kuala Lumpur, MalaysiaDepartment of Neurology, Kuala Lumpur Hospital, Jalan Pahang, 50586, Wilayah Persekutuan, Kuala Lumpur, Malaysia; Corresponding author.Objective: We detailed the electrophysiological patterns of peripheral nerve temporal dispersion across spectrum of POEMS syndrome and Castleman disease (CD). Methods: Compound muscle action potentials (CMAP) duration of 3 patients with POEMS syndrome and 2 with hyaline vascular type CD without clonal plasma cell dyscrasia were retrospectively analysed. Results: Median and ulnar nerves distal CMAP duration were prolonged in all patients irrespective of plasma cell dyscrasia or M protein. All lower limbs distal CMAP responses were absent. Greatest distal CMAP duration prolongation was observed in median nerves for POEMS syndrome (17.0 ms, 158% upper limit normal) and in ulnar nerves for CD (9.8 ms, 47% upper limit normal). Distal/proximal CMAP duration ratio of <0.7 were seen in 33% of median and ulnar nerves studied among POEMS syndrome. Among nerves with ratio >0.7, all had distal CMAP duration prolongation (Range 7%–158% of upper limit normal). Conclusions: Abnormal distal CMAP dispersion is not uncommon in POEMS syndrome and CD without clonal plasma cell dyscrasia or M protein. POEMS syndrome has greater distal CMAP duration in median and ulnar nerves, particularly in median nerve that can reach up to 150% of upper limit normal, compared to <50% in CD. Significance: Detailed electrophysiological analysis of distal CMAP duration may help in distinguishing POEMS syndrome and CD.http://www.sciencedirect.com/science/article/pii/S2467981X20300147POEMS syndromeCastleman diseaseDemyelinationCMAP durationTemporal DispersionParaproteinemic neuropathy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yue Hui Lau Hazfadzila Mohd Unit Lay Peng Lee Weng Khean Loh Fu Liong Hiew |
spellingShingle |
Yue Hui Lau Hazfadzila Mohd Unit Lay Peng Lee Weng Khean Loh Fu Liong Hiew Temporal dispersion in demyelination of POEMS syndrome and Castleman disease Clinical Neurophysiology Practice POEMS syndrome Castleman disease Demyelination CMAP duration Temporal Dispersion Paraproteinemic neuropathy |
author_facet |
Yue Hui Lau Hazfadzila Mohd Unit Lay Peng Lee Weng Khean Loh Fu Liong Hiew |
author_sort |
Yue Hui Lau |
title |
Temporal dispersion in demyelination of POEMS syndrome and Castleman disease |
title_short |
Temporal dispersion in demyelination of POEMS syndrome and Castleman disease |
title_full |
Temporal dispersion in demyelination of POEMS syndrome and Castleman disease |
title_fullStr |
Temporal dispersion in demyelination of POEMS syndrome and Castleman disease |
title_full_unstemmed |
Temporal dispersion in demyelination of POEMS syndrome and Castleman disease |
title_sort |
temporal dispersion in demyelination of poems syndrome and castleman disease |
publisher |
Elsevier |
series |
Clinical Neurophysiology Practice |
issn |
2467-981X |
publishDate |
2020-01-01 |
description |
Objective: We detailed the electrophysiological patterns of peripheral nerve temporal dispersion across spectrum of POEMS syndrome and Castleman disease (CD). Methods: Compound muscle action potentials (CMAP) duration of 3 patients with POEMS syndrome and 2 with hyaline vascular type CD without clonal plasma cell dyscrasia were retrospectively analysed. Results: Median and ulnar nerves distal CMAP duration were prolonged in all patients irrespective of plasma cell dyscrasia or M protein. All lower limbs distal CMAP responses were absent. Greatest distal CMAP duration prolongation was observed in median nerves for POEMS syndrome (17.0 ms, 158% upper limit normal) and in ulnar nerves for CD (9.8 ms, 47% upper limit normal). Distal/proximal CMAP duration ratio of <0.7 were seen in 33% of median and ulnar nerves studied among POEMS syndrome. Among nerves with ratio >0.7, all had distal CMAP duration prolongation (Range 7%–158% of upper limit normal). Conclusions: Abnormal distal CMAP dispersion is not uncommon in POEMS syndrome and CD without clonal plasma cell dyscrasia or M protein. POEMS syndrome has greater distal CMAP duration in median and ulnar nerves, particularly in median nerve that can reach up to 150% of upper limit normal, compared to <50% in CD. Significance: Detailed electrophysiological analysis of distal CMAP duration may help in distinguishing POEMS syndrome and CD. |
topic |
POEMS syndrome Castleman disease Demyelination CMAP duration Temporal Dispersion Paraproteinemic neuropathy |
url |
http://www.sciencedirect.com/science/article/pii/S2467981X20300147 |
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