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

ABSTRACT 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 s...

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Main Authors: Renata Dal-Prá Ducci, Camila Lorenzini Tessaro, Cláudia Suemi Kamoi Kay, Otto Jesus Hernandez Fustes, Lineu Cesar Werneck, Paulo José Lorenzoni, Rosana Herminia Scola
Format: Article
Language:English
Published: Thieme Revinter Publicações 2021-11-01
Series:Arquivos de Neuro-Psiquiatria
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021005023201&tlng=en
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author Renata Dal-Prá Ducci
Camila Lorenzini Tessaro
Cláudia Suemi Kamoi Kay
Otto Jesus Hernandez Fustes
Lineu Cesar Werneck
Paulo José Lorenzoni
Rosana Herminia Scola
author_facet Renata Dal-Prá Ducci
Camila Lorenzini Tessaro
Cláudia Suemi Kamoi Kay
Otto Jesus Hernandez Fustes
Lineu Cesar Werneck
Paulo José Lorenzoni
Rosana Herminia Scola
author_sort Renata Dal-Prá Ducci
collection DOAJ
description ABSTRACT 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.
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spelling doaj-art-4e3c8bdca2cc472c9f5159326f49ca6a2025-08-20T02:38:46ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42272021-11-0110.1590/0004-282x-anp-2020-0561Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overviewRenata Dal-Prá Duccihttps://orcid.org/0000-0002-1673-5074Camila Lorenzini Tessarohttps://orcid.org/0000-0002-5720-2143Cláudia Suemi Kamoi Kayhttps://orcid.org/0000-0003-0173-0809Otto Jesus Hernandez Fusteshttps://orcid.org/0000-0003-0778-5376Lineu Cesar Werneckhttps://orcid.org/0000-0003-1921-1038Paulo José Lorenzonihttps://orcid.org/0000-0002-4457-7771Rosana Herminia Scolahttps://orcid.org/0000-0002-3957-5317ABSTRACT 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021005023201&tlng=enPolyneuropathiesEpidemiologyDiagnosisElectrodiagnosis
spellingShingle Renata Dal-Prá Ducci
Camila Lorenzini Tessaro
Cláudia Suemi Kamoi Kay
Otto Jesus Hernandez Fustes
Lineu Cesar Werneck
Paulo José Lorenzoni
Rosana Herminia Scola
Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview
Arquivos de Neuro-Psiquiatria
Polyneuropathies
Epidemiology
Diagnosis
Electrodiagnosis
title Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview
title_full Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview
title_fullStr Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview
title_full_unstemmed Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview
title_short Peripheral polyneuropathy from electrodiagnostic tests: a 10-year etiology and neurophysiology overview
title_sort peripheral polyneuropathy from electrodiagnostic tests a 10 year etiology and neurophysiology overview
topic Polyneuropathies
Epidemiology
Diagnosis
Electrodiagnosis
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021005023201&tlng=en
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