The Relationship between Quiescent Inflammatory Bowel Disease and Peripheral Polyneuropathy

BACKGROUND/AIMS: Inflammatory bowel disease is a chronic, recurrent disorder that involves multiple organ systems. Polyneuropathy is the most common neurological manifestation. The aim of the present study was to investigate the relationship between polyneuropathy and inflammatory bowel disease. METHODS: The study included 40 patients with infl ammatory bowel disease (20 with ulcerative colitis and 20 with Crohn's disease) and 24 healthy controls. The patients had no clinical signs or symptoms of polyneuropathy. Nerve conduction studies were performed using an electroneuromyography apparatus. RESULTS: Mean distal motor latencies, conduction velocities, and F wave minimum latencies of the right median nerve were signifi cantly abnormal in the patient group, compared to the healthy controls (p<0.05). CONCLUSIONS: Some electrophysiological alterations were observed in chronic inflammatory bowel disease patients who showed no clinical signs. While investigating extra-intestinal manifestations in inflammatory bowel disease patients, nerve conduction studies must be performed to identify electrophysiological changes and subclinical peripheral polyneuropathy, which can subsequently develop.

Electrodiagnosis of ulnar nerve entrapment at the elbow

To evaluate the different localizing electrodiagnostic techniques of ulnar nerve entrapment at the elbow [UNE], particularly, comparison of the sensitivities of long segment stimulation across the elbow, versus short segment stimulation. Patients who were referred to the Neurophysiology Laboratory of Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey between 2000-2004 with a preliminary diagnosis of UNE were retrospectively evaluated. We compared the sensitivity of studying long segments [8-12 cm] versus short segments [3 cm] for the diagnosis of UNE in 93 limbs. The study group consisted of 55 females and 31 males. Slowing of the conduction velocity [<50 m/sn] across the elbow was recorded in 48.4% of the limbs with long segment studies, and 73% of the limbs with short segment studies. In 82% of cases, an amplitude drop of the compound muscle action potential [CMAP] was also recorded. A CMAP amplitude drop of 10-30% between the wrist and elbow was recorded in 35 limbs [37.6%], while a drop of more than 50% was only recorded in 5 limbs [5.4%]. Short segment studies are sensitive for the electrodiagnosis of UNE, and although a CMAP amplitude drop is recorded in most patients, an amplitude drop consistent with a conduction block [>50%] is rare