Identifying a therapeutic window in acute and subacute inflammatory sensory neuronopathies.

Details

Serval ID
serval:BIB_370D392A30D8
Type
Article: article from journal or magazin.
Collection
Publications
Title
Identifying a therapeutic window in acute and subacute inflammatory sensory neuronopathies.
Journal
Journal of the Neurological Sciences
Author(s)
Antoine J.C., Robert-Varvat F., Maisonobe T., Créange A., Franques J., Mathis S., Delmont E., Kuntzer T., Lefaucheur J.P., Pouget J., Viala K., Desnuelle C., Echaniz-Laguna A., Rotolo F., Camdessanché J.P., French Neuromuscular Network FILNEMUS
Contributor(s)
French Neuromuscular Network FILNEMUS, Bouhour F., Clavelou P., Gervais-Bernard H., Kleeberg J., Lagrange E., Leger JM., Nicolas G., Ochsner F., Péréon Y., Petiot P., Soichot P., Taïeb G., Vallat JM., Vial C.
ISSN
1878-5883 (Electronic)
ISSN-L
0022-510X
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
361
Pages
187-191
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
BACKGROUND: Patients with inflammatory sensory neuronopathy (SNN) may benefit from immunomodulatory or immunosuppressant treatments if administered timely. Knowing the temporal profile of neuronal loss in dorsal root ganglia will help to ascertain whether a final diagnosis may be reached before the occurrence of irreversible neuronal injuries. Thus, we addressed the evolution of neuronal loss in SNN by using sensory nerve action potentials (SNAPs) as a surrogate marker of neuron degeneration.
METHODS: Eighty-six patients with acute/subacute inflammatory SNN (paraneoplastic, associated with dysimmune diseases, or idiopathic) were retrospectively studied. The monthly SNAP reduction was determined and normalized with the lower limit of normal. Disability progression was expressed by the modified Rankin score and correlated with SNAP reduction.
RESULTS: The monthly SNAP reduction was similar in the four limbs although the median nerve was less severely affected. The monthly SNAP reduction was very severe within the first two months of evolution, began to slow down after seven months, and stabilized after ten months. It was tightly correlated with disability progression. Kaplan-Meier analysis showed that the median time until matching the diagnostic criteria of SNN was 8.5 months. Within this period, 42% of nerves remained excitable.
CONCLUSIONS: Developing treatment aiming at the stabilization of SNN is possible within the first 8 months of evolution. An improvement of the disease is possible if patients are treated within two months, which needs an early referral to an expert center and ENMG testing of the radial and ulnar nerves, which are most sensitive to changes.
Keywords
Action Potentials/physiology, Adult, Aged, Female, Ganglia, Spinal/physiopathology, Humans, Male, Median Nerve/physiopathology, Middle Aged, Peripheral Nervous System Diseases/diagnosis, Peripheral Nervous System Diseases/physiopathology, Retrospective Studies, Ulnar Nerve/physiopathology
Pubmed
Web of science
Create date
09/03/2016 11:14
Last modification date
20/08/2019 14:25
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