Case Report
Simultaneous Combined Myositis, Inflammatory Polyneuropathy, and Overlap Myasthenic Syndrome
Table 1
Motor and sensory nerve conduction studies: follow-up of our two patients.
| | | Nerve | DA | DL | NCV | | CB |
| | Patient 1 | | | | | | | | ENMG1 (year 0) | | | | | | | | Motor nerves | | | | | | | | Right | Median | 1.46 mV | 4.74 ms | 56.3 m/s | 30 ms | No | | Ulnar | 4 mV | 4.34 ms | 65.8 m/s | 31.4 ms | No | | Peroneal | 5.2 mV | 4.1 ms | 46.9 m/s | 51.9 ms | No | | Tibial | 15 mV | 4.58 ms | ND | 52.7 ms | ND | | Left | Median | 2.6 mV | 3.4 ms | 55 m/s | 31.8 ms | No | | Ulnar | 3.9 mV | 3.87 ms | 60 m/s | 31 ms | No | | Peroneal | 5.2 mV | 4.03 ms | 41.3 m/s | 50.4 ms | No | | Tibial | 9.9 mV | 4.58 ms | ND | 54.8 ms | ND | | Sensory nerves | | | | | | | | Right | Median | 8.5 µV | — | 45.5 m/s | — | — | | Ulnar | 5.8 µV | — | 57.1 m/s | — | — | | Peroneal | 0 µV | — | — | — | — | | Sural | 0 µV | — | — | — | — | | Left | Median | 6.5 µV | — | 42.7 m/s | — | — | | Ulnar | 8 µV | — | 51.6 m/s | — | — | | Peroneal | 0 µV | — | — | — | — | | Sural | 4 µV | — | 36.8 m/s | — | — | | ENMG2 (year 1) | | | | | | | | Motor nerves | | | | | | | | Right | Median | 2.9 mV | 3.55 ms | 46.3 m/s | ND | No | | Ulnar | 7.5 mV | 2.13 ms | 57.5 m/s | 30.5 ms | No | | Peroneal | 7.4 mV | 13.2 ms | 43.3 m/s | 54.1 ms | No | | Tibial | 19.4 mV | 3.32 ms | ND | 51.4 ms | ND | | Left | Median | 5.8 mV | 2.76 ms | 55.1 m/s | 27 ms | No | | Ulnar | 6.5 mV | 2.92 ms | 71.8 m/s | 27.3 ms | No | | Peroneal | 4 mV | 10.7 ms | 42.5 m/s | 50.7 ms | No | | Tibial | 8.4 mV | 3.32 ms | ND | 56.1 ms | ND | | Sensory nerves | | | | | | | | Right | Median | 9 µV | — | 49.8 m/s | — | — | | Ulnar | 4.9 µV | — | 46 m/s | — | — | | Peroneal | 0 µV | — | — | — | — | | Sural | 2.8 µV | — | 44.2 m/s | — | — | | Left | Median | 9.2 µV | — | 33.7 m/s | — | — | | Ulnar | 10.6 µV | — | 47.9 m/s | — | — | | Peroneal | 0 µV | — | — | — | — | | Sural | 0 µV | — | — | — | — | | ENMG3 (year 2) | | | | | | | | Motor nerves | | | | | | | | Right | Median | 4.1 mV | 3.24 ms | 41.4 m/s | 27.2 ms | No | | Ulnar | ND | ND | ND | ND | No | | Peroneal | 6.3 mV | 3.16 ms | 42.6 m/s | 48.3 ms | No | | Tibial | 15 mV | 3.57 ms | 35.6 m/s | 51.4 ms | ND | | Left | Median | 8.2 mV | 2.92 ms | 53.5 m/s | 29.4 ms | No | | Ulnar | ND | ND | ND | ND | No | | Peroneal | 2.6 mV | 3.79 ms | 42.8 m/s | 40.6 ms | No | | Tibial | 10.8 mV | 3.9 ms | 33.6 m/s | 56.3 ms | ND | | Sensory nerves | | | | | | | | Right | Median | 6.3 µV | — | 48.8 m/s | — | — | | Ulnar | ND | — | ND | — | — | | Peroneal | 0 µV | — | — | — | — | | Sural | 4 µV | — | 54 m/s | — | — | | Left | Median | 7.9 µV | — | 47.2 m/s | — | — | | Ulnar | ND | — | ND | — | — | | Peroneal | 0 µV | — | — | — | — | | Sural | 0 µV | — | — | — | — | | Patient 2 | | | | | | | | ENMG1 (year 0) | | | | | | | | Motor nerves | | | | | | | | Right | Median | 7.5 mV | 4.2 ms | 46.9 m/s | 33.2 ms | No | | Ulnar | 6.4 mV | 2.5 ms | 60 m/s | 32.4 ms | No | | Peroneal | 2.3 mV | 5.2 ms | 42.3 m/s | 60.3 ms | No | | Tibial | 2 mV | 5 ms | 42.4 m/s | 63.3 ms | ND | | Left | Median | 8.2 mV | 4.4 ms | 45 m/s | 32.5 ms | No | | Ulnar | 7.8 mV | 3.1 ms | 62.2 m/s | 33.1 ms | No | | Peroneal | 2.3 mV | 5.2 ms | 42.7 m/s | 60.8 ms | No | | Tibial | 1.3 mV | 4.5 ms | 44.9 m/s | 63 ms | ND | | Sensory nerves | | | | | | | | Right | Median | 6.5 µV | — | 46.3 m/s | — | — | | Ulnar | 3.5 µV | — | 32 m/s | — | — | | Peroneal | ND | — | ND | — | — | | Sural | 4.6 µV | — | 40 m/s | — | — | | Left | Median | 3 µV | — | 43.1 m/s | — | — | | Ulnar | 3.3 µV | — | 40 m/s | — | — | | Peroneal | ND | — | ND | — | — | | Sural | ND | — | ND | — | — | | ENMG2 (year 4) | | | | | | | | Motor nerves | | | | | | | | Right | Median | 6.3 mV | 6.14 ms | 45.2 m/s | 38.5 ms | No | | Ulnar | 7.1 mV | 2.65 ms | 59.5 m/s | 35.5 ms | No | | Peroneal | ND | ND | ND | ND | ND | | Tibial | 1.18 mV | 5.02 ms | ND | 61.6 ms | ND | | Left | Median | ND | ND | ND | ND | No | | Ulnar | ND | ND | ND | ND | No | | Peroneal | ND | ND | ND | ND | ND | | Tibial | ND | ND | ND | ND | ND | | Sensory nerves | | | | | | | | Right | Median | 0 µV | — | — | — | — | | Ulnar | 4.1 µV | — | 42 m/s | — | — | | Peroneal | ND | — | ND | — | — | | Sural | 2.1 µV | — | 38.9 m/s | — | — | | Left | Median | ND | — | ND | — | — | | Ulnar | ND | — | ND | — | — | | Peroneal | ND | — | ND | — | — | | Sural | ND | — | ND | — | — |
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CB: conduction block; DA: distal amplitude; DL: distal latency; F: F wave; µV: microVolt; ms: millisecond; m/s: meter/second; mV: millivolt; NCV: nerve conduction velocity.
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