The yield of sural nerve biopsy in the evaluation of peripheral neuropathies

Argov, Zohar; Steiner, Isabel; Soffer, Dov

doi:10.1111/j.1600-0404.1989.tb03745.x

Cited by 45 publications

(21 citation statements)

References 2 publications

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“…9 In our own study the percentages of patients in whom the diagnosis was altered by the biopsy was somewhat less in the axonal than the demyelinating and multiple mononeuropathy subgroups but the difference was not significant.…”

Section: Discussionmentioning

confidence: 60%

“…In a retrospective study of our own biopsies we had noted a change in diagnosis in 17% of 36 patients 8. In one retrospective study Argov et al 9 considered that nerve biopsy contributed to the diagnosis in 38% of 53 patients. In another, Neundorfer et al 10 considered that the biopsy was “crucial” for establishment of the diagnosis in 27% of 56 patients and confirmed a previously suspected diagnosis in 37%.…”

Section: Discussionmentioning

confidence: 99%

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Prospective study of the usefulness of sural nerve biopsy

Gabriel

Howard²,

Kinsella³

et al. 2000

Journal of Neurology, Neurosurgery &Amp; Psychiatry

107

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Objective-This study aimed to determine the usefulness of sural nerve biopsy in neurological practice. Methods-The first prospective study of sural nerve biopsy in 50 consecutive patients was undertaken. The investigating neurologist declared the prebiopsy diagnosis and management plan and after 3 months an independent neurologist evaluated the contribution of the biopsy to diagnosis and management. An independent audit oYcer sought information from the patient about the adverse eVects and value of the biopsy after 6 weeks and 6 months. Results-In seven cases the nerve biopsy changed the diagnosis, in 35 cases the biopsy confirmed the suspected diagnosis, and in eight cases the biopsy was noncontributory. The biopsy either changed or was helpful in guiding patient management in 60%, especially those with demyelinating neuropathy and multiple mononeuropathy. Seven patients reported having had infection and 10 reported increased pain at the biopsy site 6 months later. Conclusion-In a consecutive series of 50 cases, sural nerve biopsy altered the diagnosis in 14%, aVected management in 60%, and caused persistent increased pain at the biopsy site in 33%. (J Neurol Neurosurg Psychiatry 2000;69:442-446)

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Prospective study of the usefulness of sural nerve biopsy

Gabriel

Howard²,

Kinsella³

et al. 2000

Journal of Neurology, Neurosurgery &Amp; Psychiatry

107

View full text Add to dashboard Cite

show abstract

“…Most of the articles discussed the nerve biopsy findings in specific diseases, the clinical suspicion of which had prompted the biopsy. [23][24][25][26][27][28][29][30][31][32][33][34] No article provided guidance regarding when to perform a nerve biopsy in the evaluation of DSP.…”

Section: Analysis Of Evidencementioning

confidence: 99%

Practice Parameter: Evaluation of distal symmetric polyneuropathy: Role of autonomic testing, nerve biopsy, and skin biopsy (an evidence-based review) [RETIRED]

England¹,

Gronseth²,

Franklin³

et al. 2009

Neurology

284

142

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“…Whether suspected chronic inflammatory demyelinating polyneuropathy (CIDP) is an indication for sural nerve biopsy studies remains inconclusive from reports in the literature. Argov et al , for instance, suggest that sural nerve biopsy should be reserved for patients with a clinical picture of polyneuropathy and electrodiagnostic criteria suggestive of demyelination 3. Asbury, however, recommends the use of sural nerve biopsy only in cases of a clinical picture of mononeuritis multiplex, enlarged nerves at palpation, or for establishing diagnosis in genetically determined paediatric disorders 4.…”

mentioning

confidence: 99%

Diagnostic value of sural nerve biopsy in chronic inflammatory demyelinating polyneuropathy

Molenaar

Vermeulen

Haan

1998

Journal of Neurology, Neurosurgery & Psychiatry

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Objective-To investigate the additional diagnostic value of sural nerve biopsy of 64 patients in whom chronic inflammatory demyelinating polyneuropathy (CIDP) was considered, as sural nerve biopsy is recommended in the research criteria of an ad hoc subcommittee to diagnose CIDP. Methods-Firstly, the additional diagnostic value of sural nerve biopsy was analysed with multivariate logistic regression. Six clinical features (remitting course, symmetric sensorimotor neuropathy in arms and legs, areflexia, raised CSF protein concentration, nerve conduction studies consistent with demyelination, and absence of comorbidity or relevant laboratory abnormalities) were entered into a logistic model. Afterwards, all significant features identified from this model, as well as the results of sural nerve biopsy were forced into a second logistic model. Secondly, the diagnostic performance of a neurologist experienced in diagnosis of peripheral nerve disorders was studied by receiver operating characteristics (ROC) curve analysis. Results-The results of the first logistic analysis showed that CSF protein concentration >1 g/l (odds ratio (OR)=38.5) and neurophysiological studies consistent with demyelination (OR=51.7) were strong predictors of CIDP. When forcing the significant features and the sural nerve biopsy data into the model, an independent predictive value of sural nerve biopsy could not be found. The neurologist was able to discriminate patients with and without CIDP (area under the curve (AUC)=0.95). His diagnostic performance did not improve significantly by oVering him the results of sural nerve biopsy. Conclusion-Any additional diagnostic value of sural nerve biopsy in the diagnosis of CIDP could not be shown. (J Neurol Neurosurg Psychiatry 1998;64:84-89)

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The yield of sural nerve biopsy in the evaluation of peripheral neuropathies

Cited by 45 publications

References 2 publications

Prospective study of the usefulness of sural nerve biopsy

Prospective study of the usefulness of sural nerve biopsy

Practice Parameter: Evaluation of distal symmetric polyneuropathy: Role of autonomic testing, nerve biopsy, and skin biopsy (an evidence-based review) [RETIRED]

Diagnostic value of sural nerve biopsy in chronic inflammatory demyelinating polyneuropathy

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