Synonyms:

Polyradiculoneuropathy

Diagnosis:

The diagnosis is clinical supported by electrophysiological studies (NCS/EMG)

Clinical features:

A syndrome with involvement of multiple nerve roots and peripheral nerves. Usually equal proximal and distal weakness with reduced reflexes

Findings on investigations:

+NCS:

• Symmetrical i.e. <50% difference between sides
• Decreased SNAP
• Decreased CMAP
• Motor conduction velocities: mild decrease (remaining >75% of lower limit of normal),
• Distal latencies: normal or <25% increase
• F-waves: normal or <25% increase

+EMG:

• Denervation in paraspinal muscles and distally,

Investigations to consider:

• NCS/EMG
• MRI L-spine: lumbar spinal stenosis, compression in cauda equina syndrome
• CSF analysis including cytology: Guillain-Barre syndrome, CIDP, carcinomatous meningitis
• HIV testing
• Lyme serology
• CMV serology
• Anti-ganglioside antibodies

Causes of polyradiculopathy:

Immune:

• Guillain-Barre syndrome
• Chronic inflammatory demyelinating polyradiculopathy CIDP

Neoplastic:

• Carcinomatous meningitis
• Lymphomatous meningitis, lymphoma associated neuropathy,

Infectious:

• CMV polyradiculitis
• Lyme disease polyradiculitis

Compressive:

• Lumbar spinal stenosis
• Cauda equina syndrome

Others:

• Radiation induced radiculopathy (formerly radiation induced lower motor neuron syndrome)

Related articles:

• Approach to weakness, approach to sensory deficits, neuromuscular disease patterns, nerve diseases,
• Radiculpathy, polyneuropathy, plexopathy (brachial and lumbosacral), Radiculopathy,
• Guillain-Barre syndrome, CIDP, brain tumor, meningitis, myelopathy/cauda equina syndrome, lumbar spinal stenosis,