Peripheral nervous system involvement in multiple sclerosis

Objective: To investigate possible peripheral nervous system (PNS) affection in patients with multiple sclerosis (MS) by standard nerve conduction velocity (SNC) and pain-related evoked potentials (PREP), a novel electrophysiological method for diagnosing small fibre neuropathy. Background: Former neuropathological and electrophysiological studies demonstrated subtle PNS affection in MS, but routine measurements are mostly normal. Small fibre polyneuropathy is associated with several autoimmune diseases but has not been investigated in MS yet. Design/Methods: Fifty-four patients with MS (43 relapsing-remitting, 11 secondary progressive MS) underwent SNC of the tibial, sural and peroneal nerve. Twenty-one patients additionally underwent PREP. Results: SNC abnormalities were observed in 29.6% of all patients and 14.2% of all nerves examined No abnormalities on PREP were found. Conclusions/Relevance: We demonstrated subtle alterations on routine electrophysiological measurements in patients with MS without hints for small fibre pathology.