Triple-stimulation technique in multifocal neuropathy with conduction block

Muscle Nerve. 2007 May;35(5):632-6. doi: 10.1002/mus.20742.

Abstract

In patients with multifocal neuropathy with conduction block (CB), CBs located between the root and Erb's point are not detected in nerve conduction studies. We therefore examined whether the triple-stimulation technique (TST) might provide a useful means of detecting CB proximal to Erb's point. Clinical assessments, extensive nerve conduction studies (NCS), conventional transcranial magnetic stimulation, and TST were performed on 10 patients with multifocal motor neuropathy with CB (MMNCB) and 6 patients with Lewis-Sumner syndrome. Conduction blocks located proximal to Erb's point were detected in 9 patients. Of the CBs, 58% were associated with muscle weakness. The use of TST to detect proximal CB improved the sensitivity of the American Association of Neuromuscular and Electrodiagnostic Medicine criteria for definite or probable MMNCB from 60% to 90%. Thus, the TST is a useful means for detection of proximal CB and gives NCS considerable additional diagnostic power.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Electric Stimulation / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Neuron Disease / diagnosis*
  • Motor Neuron Disease / physiopathology*
  • Neural Conduction*
  • Sensitivity and Specificity
  • Syndrome