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Título

ELECTRODIAGNOSTIC CHARACTERISTICS OF SENSORY GANGLIONOPATHIES

Resumo

Introduction: the term sensory ganglionopathy refers to the pathological process in which there is involvement of the sensory component, both central and peripheral. In most cases patients will have preserved strength despite sensory involvement. To recognize this pathology, associated with malignancies and other potentially treatable diseases, allows the patient to undergo specific treatments. The differentiation from polyneuropathies is important and nerve conduction studies are particularly useful, since the distribution of ganglionopathy is not length-dependent and often asymmetrical.
Goals: describe the electrodiagnostic (EDX) findings on a series of patients cases with ganglionopathy, obtained in the NCS/EMG laboratory.
Methods: retrospective study based on EDX exams from the Hospital das Clínicas of the University of São Paulo in the last 8 years. Electrophysiological criteria similar to those used by Camdessanche were applied. Sensory changes were considered length-dependent if the sural/radial ratio was below 20% bilaterally. Sensory asymmetry was considered when we observed a side-by-side difference above 50% of the sensory potential amplitude. The following data were evaluated: sex, age, etiology, presence of ataxia and characteristics obtained from EDX: sensory and motor conduction amplitudes and velocities, late responses and assessment of the blink reflex.
Results: 27 patients were identified between November 2014 and April 2022. There was a predominance of females 77% (20). The age of the patients ranged from 11 to 86 years (mean: 53.5). About 88% of the cases (26) met Candessanche criteria for ganglionopathy. We observed asymmetry in the sensory action potentials in 53% (14) of the cases. Six cases (23%) had a length dependent distribution according to sural/radial ratio.
There was a predominance of Sjögren's syndrome in 34% (9) and undetermined etiology in 34% (9), neoplasms in 27% (7), celiac disease in 7% (2), in addition to isolated cases of other etiologies. The H reflex was not obtained in 88% (23) of the cases. The blink reflex was altered in 75% of the cases, but the test was done in only 8 cases.
Conclusion: Our cases were compatible with Candessanche criteria. It was also possible to observe non-length dependence, predominance of this pathology in females and motor involvement in paraneoplastic etiologies. An important finding is that sural/radial ratio may not differentiate sensory ganglionopathy from polyneuropathy in isolation.

Palavras Chave

Sensory Ganglionopathy, Electrodiagnostic, Camdessanché Criteria, Peripheral Nerves.