CRITERIA FOR EARLY DETECTION OF CONDUCTION BLOCK IN MULTIFOCAL MOTOR NEUROPATHY (MMN) - A STUDY BASED ON CONTROL POPULATIONS AND FOLLOW-UP OF MMN PATIENTS
A. Cappellari et al., CRITERIA FOR EARLY DETECTION OF CONDUCTION BLOCK IN MULTIFOCAL MOTOR NEUROPATHY (MMN) - A STUDY BASED ON CONTROL POPULATIONS AND FOLLOW-UP OF MMN PATIENTS, Journal of neurology, 244(10), 1997, pp. 625-630
Motor conduction block (MCB) has been used as the main diagnostic crit
erion in multifocal motor neuropathy (MMN). Nonetheless, no agreed def
inition of block currently exists; the proposed required percent decre
ment of proximal compound muscle action potential (CMAP) amplitude var
ies from > 20% to > 50%. The aim of this work was to-evaluate, through
a follow-up study of patients with MMN, the behaviour of MCB over tim
e. The percent decrement and temporal dispersion of proximal CMAP have
also been calculated in normal controls and in patients affected by a
myotrophic lateral sclerosis (ALS). The results show that MCB in patie
nts with MMN is a dynamic entity which greatly varies over time and th
at a > 50% CMAP amplitued reduction may well be preceded by a smaller
decrement that is nonetheless indicative of focal myelin damage in the
appropriate clinical context. This datum and the results obtained in
the control group and in patients with ALS suggest that a reappraisal
of the diagnostic criteria for MCB, in cases with clinical and electro
physiological data strongly indicative of MMN, should be considered. S
ince MMN is a treatable disorder, the use of the proposed less restric
tive criteria for the identification of MCB could allow for a promp an
d more effective treatment.