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- Title
Electrophysiology in the Early Diagnosis of Chemotherapy-Induced Distal Symmetric Polyneuropathy.
- Authors
KARAAĞAÇ, Melih Mete; MATUR, Zeliha
- Abstract
Introduction: Many drugs used in cancer treatment exert toxic effects on peripheral nerves, often resulting in distal symmetric sensory polyneuropathy (DSP). Early diagnosis of polyneuropathy is crucial for guiding treatment. This project establishes a new electrophysiological ratio for the early diagnosis of DSP. Method: Sixteen patients with chemotherapy-induced DSP (34-78 years) and 23 healthy volunteers (35-78 years) were included in the study. The patient group comprised cancer patients referred to the electromyography (EMG) laboratory with a preliminary diagnosis of chemotherapy-induced polyneuropathy. EMG examination involved radial, median, ulnar, superficial peroneal, sural, medial femoral cutaneous, and mixed medial plantar sensory; as well as motor nerve conduction studies. Sensory amplitude ratios, including sural/radial (SRR), medial femoral cutaneous/radial (MFCRR), and medial plantar/radial (MPRR), were calculated. Results: All patients reported burning or numbness of the feet or hands. Neurological examination revealed hypoalgesia/paresthesia in the distal lower extremities, loss of distal deep tendon reflexes, and decreased or absent vibration sensation in the distal lower extremities. The MNST-A scores had a median of 5, and the MNST-B scores had a median of 4.5. Medial plantar responses were bilaterally absent in 10 patients and unilaterally absent in one. SRR, MFCRR, and MPRR mean values were significantly lower in patients than in the control group (p<0.001). MPRR demonstrated the highest sensitivity (45%) and specificity (90%) in discriminating patients from normals. Conclusion: In this study, it was observed that chemotherapy-induced neuropathy occurs most frequently in sensory nerves, with less impact on motor nerves. The most significant impact was observed in the distal medial plantar response, which was measured at the most distal point in the lower extremities. In mild cases, MPRR was found to be the most useful ratio for differentiating patients from volunteers.
- Subjects
POLYNEUROPATHIES; NERVE conduction studies; EARLY diagnosis; CHEMOTHERAPY complications; POISONS; PERIPHERAL nervous system
- Publication
Bezmialem Science, 2024, Vol 13, pS12
- ISSN
2148-2373
- Publication type
Abstract