PERIPHERAL NEUROPATHY IN MULTIPLE-SCLEROSIS - A CLINICAL AND ELECTROPHYSIOLOGIC STUDY

Peripheral nerve abnormalities are uncommon in multiple sclerosis (MS) . When present, they are usually attributed to factors associated with advanced disease, such as malnutrition or cytotoxic drugs. We prospec tively evaluated 22 mildly disabled MS patients with sensory complaint s for evidence of neuropathy using the Neuropathy Symptom Score (NSS), clinical examination, and electrophysiologic studies of peripheral ne rves. Distal latency, F-wave response, and nerve conduction velocity ( NCV) and amplitude in the ulnar, median, tibial, peroneal and sural ne rves were examined. Neuropathy was recorded if electrophysiologic abno rmalities were detected in at least two peripheral nerves in the same patient, The most frequent electrophysiologic abnormalities noted were prolonged F-wave response and low motor amplitude in the peroneal ner ve, slow sensory conduction velocities of the ulnar and sural nerves, and prolonged distal latencies in the sensory ulnar and sural nerves. Electrophysiologic abnormalities were found in 33 of 244 nerves examin ed (14.7%) and occurred in 10 patients (45.5%). Neuropathic symptoms w ere mild and did not correlate with electrophysiologic abnormalities. Age, disease duration, disease course and neurologic disability as eva luated by the Kurtzke Expanded Disability Status Scale, were not assoc iated with the presence of neuropathy. Our findings indicate a high fr equency of sensory-motor neuropathy in a selected group of MS patients .