These criteria are applied by testing the median, ulnar (stimulated below the elbow), peroneal (stimulated below the fibular head), and tibial nerves on one side of the body. During testing, limb temperature should be no less than 33°C at the palm and no less than 30°C at the external malleolus.
Definite CIDP
At least one of the following demyelinating parameters are necessary:
- >/= 50 percent prolongation of motor distal latency above the ULN in two nerves
- >/= 30 percent reduction of motor conduction velocity below the LLN in two nerves
- >/= 20 percent prolongation of F-wave latency above the ULN in two nerves, or >50 percent if the amplitude of the distal negative peak compound muscle action potential (CMAP) is <80 percent of the LLN
- Absence of F-waves in two nerves, if these nerves have amplitudes of distal negative peak CMAPs >/= 20 percent of the LLN, plus at least one other demyelinating parameter (meeting any of the definite criteria) in at least one other nerve
- Partial motor conduction block, defined by a >/= 50 percent amplitude reduction of the proximal negative peak CMAP relative to distal, if distal negative peak CMAP is >/= 20 percent of the LLN, in two nerves, or in one nerve plus at least one other demyelinating parameter (meeting any of the definite criteria) in at least one other nerve
- Abnormal temporal dispersion, defined by a >30 percent duration increase between the proximal and distal negative peak CMAP in at least two nerves
- Distal CMAP duration (interval between onset of the first negative peak and return to baseline of the last negative peak) of [greater than or equal to]9 ms in at least one nerve plus at least one other demyelinating parameter (meeting any of the definite criteria) in at least one other nerve
Probable CIDP
>/= 30 percent amplitude reduction of the proximal negative peak CMAP relative to the distal, excluding the posterior tibial nerve, if the distal negative peak CMAP is >/= 20 percent of LLN, in two nerves, or in one nerve plus at least one other demyelinating parameter (meeting any of the definite criteria) in at least one other nerve
Possible CIDP
As in “Definite CIDP” but in only one nerve
ULN: Upper limit of normal; LLN: Lower limit of normal.
References:
- Hughes RA, Bouche P, Cornblath DR, Evers E, Hadden RD, Hahn A, Illa I, Koski CL, Léger JM, Nobile-Orazio E, Pollard J, Sommer C, Van den Bergh P, van Doorn PA, van Schaik IN. European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. Eur J Neurol. 2006 Apr;13(4):326-32. [Medline]
- Joint Task Force of the EFNS and the PNS. European Federation of Neurological Societies/Peripheral Nerve Society Guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. J Peripher Nerv Syst. 2005 Sep;10(3):220-8. [Medline]
Created: Oct 27, 2009
