scholarly journals On the question of differential diagnosis of multifocal motor neuropathy

2020 ◽  
Vol 12 (1) ◽  
pp. 89-96
Author(s):  
Mariia G. Sokolova ◽  
Sergei V. Lobzin ◽  
Andrey A. Zuev ◽  
Vladimir G. Pustozerov ◽  
Nicolay Yu. Aleksandrov ◽  
...  
Keyword(s):  
Clinical Case ◽  
Disease Onset ◽  
Multifocal Motor Neuropathy ◽  
Differential Diagnostics ◽  
Motor Neuropathy ◽  
Motor Neuron Diseases ◽  
Number Of Factors ◽  
Incorrect Diagnosis ◽  
Peripheral Motor ◽  
Lateral Sclerosis

Differential diagnostics of multifocal motor neuropathy (MMN) has many difficulties associated with a number of factors: rare nature of disease, polymorphic clinical forms and a phenotypic picture similar to peripheral motor neuron diseases. Such diseases also include rare nosological forms: amyotrophic lateral sclerosis, hereditary myopathies and neuropathies; their general phenotypic picture has a form of progressive flaccid paralysis, age of the disease onset and the nature of its course. However, different pathogenesis of these diseases requires a differentiated approach to therapy. This article deals with differential diagnostics of multifocal motor neuropathy, gives examples of modern diagnostic criteria necessary for diagnosing multifocal motor neuropathy and analyzes a clinical case with an incorrect diagnosis of multifocal motor neuropathy.

scholarly journals Amyotrophic Lateral Sclerosis versus Multifocal Motor Neuropathy: Utility of MR Neurography

Radiology ◽  
2019 ◽  
Vol 292 (1) ◽  
pp. 149-156 ◽  
Author(s):  
Moritz Kronlage ◽  
Karl Christian Knop ◽  
Daniel Schwarz ◽  
Tim Godel ◽  
Sabine Heiland ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Multifocal Motor Neuropathy ◽  
Motor Neuropathy ◽  
Mr Neurography ◽  
Lateral Sclerosis

scholarly journals Nerve ultrasound for differentiation between amyotrophic lateral sclerosis and multifocal motor neuropathy

2015 ◽  
Vol 262 (4) ◽  
pp. 870-880 ◽  
Author(s):  
Alexander Grimm ◽  
Bernhard F. Décard ◽  
Ioanna Athanasopoulou ◽  
Kathi Schweikert ◽  
Michael Sinnreich ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Multifocal Motor Neuropathy ◽  
Motor Neuropathy ◽  
Nerve Ultrasound ◽  
Lateral Sclerosis

Distal Arm Weakness

2018 ◽  
Author(s):  
Aziz Shaibani
Keyword(s):  
Joint Pain ◽  
Distinct Group ◽  
Multifocal Motor Neuropathy ◽  
Motor Neuropathy ◽  
Loss Of Function ◽  
Cerebellar Disease ◽  
Hand Muscles ◽  
Normal Strength ◽  
Intrinsic Hand Muscles ◽  
Lateral Sclerosis

Distal arm weakness may be caused by involvement of the intrinsic hand muscles (interossi, thenar and hypothenar muscles, lumbricals) or extrinsic hands muscles (long fingers flexors and extensors). Amyotrophic lateral sclerosis (ALS) is typical of the former type, and inclusion body myositis (IBM) is typical for the later type. Incoordination of skilled finger movement due to cerebellar disease is associated with normal strength. Poor mobility due to joint pain and swelling should not be confused with muscle weakness. Mononeuropathies such as ulnar, radial, median, and anterior interosseus nerve lesions usually cause differential loss of function. Myasthenia gravis sometimes causes weakness of the wrist and finger extensors. A small but distinct group of distal hereditary myopathies should always be kept in mind. Progressive sensorimotor neuropathies are usually associated with sensory symptoms. Multifocal motor neuropathy can be a challenging diagnosis.

Disorders of single nerves, roots, and plexuses

2016 ◽  
Author(s):  
Kerry R. Mills
Keyword(s):  
Nerve Conduction ◽  
Cervical Radiculopathy ◽  
Multifocal Motor Neuropathy ◽  
Nerve Conduction Studies ◽  
Motor Neuropathy ◽  
Vasculitic Neuropathy ◽  
Brachial Neuritis ◽  
Pressure Palsies ◽  
Lateral Sclerosis

The role of electromyography (EMG) and nerve conduction studies in disorders of single nerve, root, and plexus lesions are discussed. The motor and sensory anatomy underpinning diagnosis is described and a scheme presented showing the key muscles to be examined using EMG to differentiate nerve, plexus, and root lesions. The main causes of mononeuritis multiplex, of either axonal degeneration or demyelinative pathology, are covered, including diabetic neuropathy, vasculitic neuropathy, multifocal motor neuropathy with block, and the Lewis–Sumner syndrome. The confirmatory role of EMG and nerve conduction studies in the investigation of cervical and lumbar radiculopathies is highlighted as is the use of transcranial magnetic stimulation to differentiate cervical radiculopathy with myelopathy from amyotrophic lateral sclerosis. The neurophysiological hallmarks of traumatic cervical plexus lesions, including obstetric causes, inherited and acquired brachial neuritis, hereditary liability to pressure palsies, the cervical rib syndrome, and radiation plexopathy are also covered.

Comparative study of peripheral nerve Mri and ultrasound in multifocal motor neuropathy and amyotrophic lateral sclerosis

2016 ◽  
Vol 54 (6) ◽  
pp. 1133-1135 ◽  
Author(s):  
Bas A. Jongbloed ◽  
Wieke Haakma ◽  
H. Stephan Goedee ◽  
Jeroen W. Bos ◽  
Clemens Bos ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Peripheral Nerve ◽  
Comparative Study ◽  
Multifocal Motor Neuropathy ◽  
Motor Neuropathy ◽  
Lateral Sclerosis

scholarly journals One nerve suffices: A clinically guided nerve ultrasound protocol for the differentiation of multifocal motor neuropathy (MMN) and amyotrophic lateral sclerosis (ALS)

2020 ◽  
Author(s):  
Kai F. Loewenbrück ◽  
Robin Werner ◽  
René Günther ◽  
Markus Dittrich ◽  
Robert Klingenberger ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Diagnostic Accuracy ◽  
Site Selection ◽  
Multifocal Motor Neuropathy ◽  
Receiver Operating Curve ◽  
Motor Neuropathy ◽  
Nerve Ultrasound ◽  
Convenience Sample ◽  
Clinical Deficits ◽  
Lateral Sclerosis

Abstract Objective To investigate diagnostic accuracy of a nerve ultrasound (US) protocol that is individualized to a patient’s clinical deficits for the differentiation of amyotrophic lateral sclerosis with predominant lower motoneuron disease (ALS/LMND) and multifocal motor neuropathy (MMN). Methods Single-center, prospective, examiner-blinded, diagnostic study in two cohorts. Cohort I (model development): Convenience sample of subjects with ALS/LMND or MMN according to revised El-Escorial or EFNS guidelines. Cohort II (model validation): Consecutively recruited treatment-naïve subjects with suspected diagnosis of ALS/LMND or MMN. Cutoffs for 28 different US values were determined by Receiver Operating Curve (ROC) in cohort I. Area Under The Curve (AUC) of US was compared to nerve conduction studies (NCS). Diagnostic accuracy of US protocols, individualized according to clinical deficits, was compared to former rigid non-individualized protocols and to random examination site selection in cohort II. Results 48 patients were recruited. In cohort I (28 patients), US had higher ROC AUCs than NCS, US 0.82 (0.12) (mean (standard deviation)), NCS (compound muscle action potential (CMAP) 0.60 (0.09), p < .001; two-sided t-test). US models based on the nerve innervating the clinically most affected muscles had higher correct classification rates (CCRs, 93%) in cohort II than former rigid protocols (85% and 80%), or models with random measurement site selection (66% and 80%). Conclusions Clinically guided US protocols for differentiation of ALS/LMND from MMN increase diagnostic accuracy when compared to clinically unguided protocols. They also require less measurements sites to achieve this accuracy.

Sign in / Sign up

Export Citation Format

Share Document