Abstract Details

Title Natural History of Lumbosacral Radiculoplexus Neuropathy

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) S42 - Neuromuscular Disorders (3:30 PM-3:41 PM)

Poster/Presentation
Number 001

Background Recently, our group found that the incidence of LRPN in Olmsted County, Minnesota, is 4.16/100,000/year, which is almost three times the incidence of CIDP or GBS in the same population. Although LRPN clinical, laboratory, pathological and neurophysiological findings have been described, its long-term natural history has not been systematically characterized.

Objective

To characterize the natural history (clinical outcome and survival) of Lumbosacral Radiculoplexus Neuropathy (LRPN).

Design/Methods 62 LRPN episodes in 59 patients defined by clinical and electrophysiological criteria were identified over a 16 year-period (2000-2015) using the Rochester LRPN Epidemiology Project. Demographic, clinical and survival data were extracted. Survival and mortality risk factors were compared to age-gender matched controls.

Results At diagnosis, LRPN patients median age was 70 (24-88) years, median neuropathy impairment score (NIS) 22 points (1-102), pain and weakness were present in 92% and 95% respectively, 24% were wheel-chair bound and median modified Rankin scale (mRS) was 3 (1-4). The median time from diagnosis to last neurological follow-up was 8 (4-49) months, and the median NIS had improved to 17 points (0-56)(p<0.001). 56% had improvement of ≥4 points in NIS score, 12% were wheel chair-bound, 55% had pain and 83% weakness and median mRS was 2 (0-4). LRPN survival after 5 and 10 years was 86% and 55% respectively. Compared to age-gender matched controls, LRPN increased risk of death by 76% (p=0.0164). In multivariate mortality risk factor analysis, diabetes mellitus, chronic kidney disease, stroke and age were significant risk factors but LRPN was not. There were no significant differences in survival between diabetic and non-diabetic LRPN.

Conclusions LRPN usually improves over time but people are often left with significant functional impairment. Although having LRPN increases mortality risk, it is probably due to higher prevalence of diabetes mellitus and other comorbidities rather than LRPN itself.

Authors/Disclosures
Marcus Vinicius R. Pinto, MD (Mayo Clinic) PRESENTER	Dr. Pinto has nothing to disclose.
Peng Soon Ng, MBBS (Neurology Care Partners Pte. Ltd.)	No disclosure on file
	No disclosure on file
Ruple S. Laughlin, MD, FAAN (Mayo Clinic Rochester)	Dr. Laughlin has nothing to disclose.
Peter J. Dyck, MD, FAAN (Mayo Clinic)	Dr. Dyck has nothing to disclose.
P. James B. Dyck, MD, FAAN (Mayo Clinic)	Dr. Dyck has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Akcea/Ionis.

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