Terminal latency index in neuropathy with antibodies against myelin-associated glycoproteins

Muscle Nerve. 2007 Feb;35(2):196-202. doi: 10.1002/mus.20678.

Abstract

Neuropathy with antibodies against myelin-associated glycoproteins (MAG/SGPG-N) and hereditary sensorimotor neuropathy type 1 (HMSN1) are characterized by chronic demyelination with little conduction block. Electrodiagnostic studies suggest that in HMSN1 conduction slowing occurs uniformly along the nerve, whereas in MAG/SGPG-N it is predominantly distal. Some but not all previous reports have shown that the terminal latency index (TLI) was useful to distinguish MAG/SGPG-N from chronic idiopathic demyelinating polyneuropathy. We compared median TLI from 21 patients with MAG/SGPG-N with those obtained from 26 patients with HMSN1, 20 with HMSN2, and 12 healthy volunteers. All patients with TLI <0.26 had MAG/SGPG-N, and all patients with TLI > or =0.32 had HMSN1. In the remaining patients with intermediate TLI values, ulnar distal motor latency (DML) aided in differentiation between MAG/SGPG-N and HMSN1 with an overall sensitivity of 100% and specificity of 98%. In conclusion, median TLI in combination with ulnar DML can further guide the demyelinating neuropathy evaluation toward hereditary or autoimmune causes.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Intramural

MeSH terms

  • Action Potentials / physiology
  • Action Potentials / radiation effects
  • Adult
  • Aged
  • Antibodies / blood*
  • Charcot-Marie-Tooth Disease / physiopathology*
  • Electromyography
  • Female
  • Humans
  • Male
  • Median Nerve / physiopathology
  • Middle Aged
  • Myelin-Associated Glycoprotein / immunology*
  • Neural Conduction / physiology
  • Peripheral Nervous System Diseases / immunology*
  • Peripheral Nervous System Diseases / physiopathology*
  • Reaction Time / physiology*
  • Ulnar Nerve / physiopathology

Substances

  • Antibodies
  • Myelin-Associated Glycoprotein