Medicinski pregled 2010 Volume 63, Issue 7-8, Pages: 559-564
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Importance of electromiographic examination in diagnostification and monitoring of chronic inflammatory demyelinating polyneuropathy

Damjan Igor, Cvijanović Milan, Erak Marko

Introduction. Polyneuropathies or peripheral neuropathies present a dysfunction or disease of larger number of peripheral nerves or their dysfunction. Considering their morbidity - mortality characteristics they present an important aspect in daily clinical practice. One particular polyneuropathy that deserves special review is chronic inflammatory demyelinating polyneuropathy, which, due to its clinical - laboratory presentation, does not include the group of „simple” neuropathies, thus requiring further examinations. Neurophysiological testing should be performed using the protocol for neuropathy examinations. Neurophysiological examination, during the electroneurographic examination, shows neurographic parameters referring to polyneuropatic demyelinating type of lesion, while the electromyographic finding records the presence of neuropathic lesions (denervation activity, great action potentials with a reduced sample). Case report. A 54-year-old patient was diagnosed to have a “complicated” demyelinating polyneuropathy according to the clinical-laboratory findings and electromyographic examination. Exclusion criteria, targeted diagnostic examinations, considering the mentioned peripheral neuropathies, pointed to acute inflammatory demyelinating polyneuropathy. However, the chronic inflammatory demyelinating polyneuropathy was finally differentiated during the clinical and electromyographic monitoring. Conclusion. The presented case is interesting because it shows how one can ”wander” towards the diagnosis, which is eventually made on the basis of electromyographic examination and monitoring as well as according to exclusion criteria, which have differentiated the acute inflammatory demyelinating polyneuropathy from the chronic one.

Keywords: Electromyography, Polyneuropathies, Chronic Disease, Demyelinating Diseases, Neurologic Examination, Physical Examination, Diagnosis, Differential, Male

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