The additional diagnostic value of motor nerve excitability testing in chronic axonal neuropathy

Thomas Krøigård*, Ulrik Sodemann, Laura M. Gaist, Søren H. Sindrup, Hatice Tankisi


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Objective: To explore potential differences in motor nerve excitability testing (NET) variables at group levels between patients with a clinical diagnosis of polyneuropathy (PNP), which did not fulfil diagnostic criteria of conventional nerve conduction studies (NCS) and patients without polyneuropathy. Such differences could support a role for NET in increasing the diagnostic sensitivity of NCS in chronic axonal PNP. Methods: Motor NET was performed using the median nerve in patients with a clinical suspicion of PNP in addition to conventional NCS, skin biopsies, corneal confocal microscopy and structured clinical evaluation including scoring of neuropathy symptoms and signs. Results: Of the 57 patients included, 32 had PNP, half of which had NCS, which fulfilled criteria for PNP (NCS+ PNP). There were no significant differences for any of the NET variables between PNP patients with non-diagnostic conventional NCS (NCS− PNP) and patients without PNP. Rheobase was increased, and Ted (undershoot) and subexcitability were decreased in NCS+ PNP. Sural amplitude, peroneal nerve F-wave latency and tibial nerve F-wave-latency were correlated with subexcitability, and tibial nerve motor amplitude was correlated with rheobase. Conclusions: NET was correlated with conventional NCS and no differences were found between NCS− PNP patients and patients without PNP. Significance: NET does not seem to offer any additional diagnostic value in chronic mixed etiology neuropathy.

TidsskriftClinical Neurophysiology Practice
Sider (fra-til)27-33
StatusUdgivet - jan. 2022

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© 2022 International Federation of Clinical Neurophysiology


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