 |
|
Chronic Idiopathic Axonal Polyneuropathy and Successful Aging of the Peripheral Nervous System in Elderly People
Alexander F. J. E. Vrancken, MD;
Hessel Franssen, MD, PhD;
John H. J. Wokke, MD, PhD;
Laurien L. Teunissen, MD;
Nicolette C. Notermans, MD, PhD
Arch Neurol. 2002;59:533-540.
Background Chronic idiopathic axonal polyneuropathy (CIAP) is a frequent neurologic
disorder in elderly persons. In view of the aging population, it is important
to know the long-term prognosis of CIAP.
Objectives To determine if CIAP is influenced by the superposition of the effects
of aging and to evaluate the severity of CIAP according to the disease duration.
Design Controlled cohort study.
Setting Outpatient clinic for neuromuscular diseases at the University Medical
Center Utrecht, Utrecht, the Netherlands.
Participants and Methods One hundred twenty-seven patients with CIAP and 108 age-matched control
subjects were included. We defined CIAP on the basis of symmetrical distal
sensory or sensorimotor symptoms and signs with evolution over at least 6
months, exclusion of causes by history taking, results of clinical and laboratory
investigations, and electrophysiologic findings that agreed with the diagnosis
of axonal polyneuropathy.
Results No important neurologic or electrophysiologic differences were found
between patients with early-onset (before the age of 65 years) and late-onset
(at or after the age of 65 years) CIAP, but patients with early-onset CIAP
who had a short disease duration (<10 years) experienced more disability
than patients with late-onset CIAP who had a similar disease duration. Old
controls (age of 65 years or older) more often had symptoms, sensory signs
in the legs, absent ankle jerks, and lower mean distal amplitudes of compound
muscle action potentials and sensory nerve action potentials than young controls
(aged <65 years). Absence of the sural nerve sensory nerve action potentials
or presence of spontaneous muscle fiber activity in the anterior tibial muscle
was common in patients with CIAP (51% and 60%, respectively), but exceptional
(both 2%) in controls.
Conclusions Neither aging of the peripheral nervous system nor disease duration
affects CIAP to a considerable degree, but CIAP has a greater influence on
the daily life of nonretired patients with early-onset CIAP. The diagnosis
of axonal polyneuropathy is probably supported best by either the absence
of the sural nerve sensory nerve action potentials or the presence of spontaneous
muscle fiber activity in the anterior tibial muscle.
From the Departments of Neurology (Drs Vrancken, Wokke, Teunissen,
and Notermans) and Clinical Neurophysiology (Dr Franssen), University Medical
Center Utrecht, Utrecht, the Netherlands.
RELATED ARTICLES
Chronic Idiopathic Axonal Polyneuropathy and Successful Aging of the Peripheral Nervous System
Gil I. Wolfe
Arch Neurol. 2002;59(4):520-522.
EXTRACT
| FULL TEXT
Archives of Neurology Reader's Choice: Continuing Medical Education
Arch Neurol. 2002;59(4):655-656.
FULL TEXT
|
