CIDP Learning Zone
Transcript: Technologies for the diagnosis of CIDP
Eduardo Nobile-Orazio, MD, PhD
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The mandatory test, and the one which is most useful, and you make a diagnosis in 90% or 80% of the case, is nerve conduction studies. That is the test. If I have a suspicion of a patient who has this and, you know, the first thing I do, is ask for nerve conduction studies. I ask to do nerve conduction studies in the four limbs, or at least in two limbs, in one limb, in one upper limb and one lower limb, and do sensory and motor. And do to have all the tests, let's say nerve conduction velocity, CMAP amplitude, temporal dispersion, all of these parts of which are necessary.
Electromyography and say muscle examination is not that important, but nerve conduction studies are critical. And of course, even if the guideline, the main point in the guideline, are the clinical presentation and nerve conduction studies. So, if you have these two points with a disease that is progressing at least over two months with weakness and sensory impairment, which may be sometimes just sensory, sometimes just motor, but they are very minority. You know, they vary in their typical presentation of 10 to 15%, they are mostly sensory motor, then the second point is nerve conduction studies.
If you have diagnostic nerve conduction studies, you find conduction block, reduced velocity, increased latency, or, you know, delay the F-wave latency, you know, then you can make a diagnosis. We did a study where we show in the Italian database that despite the fact that say 70%, I mean, we had out of 450, when we look at the data, 350 did a lumbar puncture examination. And in about just 50 of them, they were helpful in supporting the diagnosis. In all the other patients the diagnosis could be just made with clinical examination, history of the patient, clinical examination, and nerve conduction studies.
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