title: Electrophysiological features of POEMS syndrome and chronic inflammatory demyelinating polyneuropathy.
abstract: Polyneuropathy is often an initial manifestation of polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes (POEMS) syndrome and therefore this disorder is frequently misdiagnosed as chronic inflammatory demyelinating polyneuropathy (CIDP). We reviewed electrophysiological data in 20 patients with POEMS syndrome and 36 matched patients with CIDP to compare the electrophysiological features of POEMS syndrome and CIDP. Compared with CIDP controls, POEMS patients demonstrated (1) less prolonged distal motor latency and less reduced motor nerve and sensory nerve conduction velocities, (2) greater reduction of amplitudes of compound motor action potentials (CMAP) in distal stimulation, and similar reduction of amplitudes of CMAP in proximal stimulation, (3) similar reduction of amplitudes of sensory nerve action potentials (SNAP) in median and ulnar nerves, and a greater reduction of amplitudes of SNAP in tibial and peroneal nerves, (4) less temporal dispersion, (5) less frequent conduction block, (6) more frequent neurogenic injury in the muscles of the upper and lower limbs, and more frequent neurogenic injury in the muscles of the lower than upper limbs, (7) similar F wave and H reflex abnormalities, and (8) less frequent skin sympathetic response abnormalities. We concluded that before development of typical clinical manifestations, POEMS neuropathy can be distinguished from CIDP by neural electrophysiological examination. These electrophysiological features can be used for early diagnosis and initiating correct treatment of POEMS syndrome.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China.
authors.forename: Xiuming
authors.initials: X
authors.lastname: Guo
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China.
authors.forename: Xinyue
authors.initials: X
authors.lastname: Qin
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China.
authors.forename: Yuping
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China. Electronic address: yugangw@yahoo.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D019054:Evoked Potentials, Motor; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D009431:Neural Conduction; D016878:POEMS Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D010543:Peroneal Nerve / Q000503:physiopathology; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000175:diagnosis* / Q000503:physiopathology*; D012018:Reflex; D012189:Retrospective Studies; D012879:Skin Physiological Phenomena; D013979:Tibial Nerve / Q000503:physiopathology; D014459:Ulnar Nerve / Q000503:physiopathology
keywords: CIDP; Diagnosis; Electromyography; POEMS syndrome