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Clinical Indications for Measurement:

• Diagnostic work-up of
  • Gait disorder, accompanied by
  • Symmetric polyneuropathy with distal sensory loss
  .
• Clinical features that increase probability of a positive result
  • Age > 50 years
  • Prominent falling
  • Serum IgM M-protein
  • Demyelination without conduction block on electrodiagnostic studies.

Positive Result: Clinical Utility and Interpretations

• Specificity: >90%
• Diagnostic:
  • May be only positive diagnostic test in a patient with a neuropathy and gait disorder
    • This is especially helpful in patients whose neuropathy or gait disorder would otherwise be labeled as idiopathic.
  • Provides independent support for a diagnosis of an immune-mediated sensory-motor or sensory polyneuropathy.
    • The neuropathy may be either demyelinating or axonal.
    • Suggests treatment possibilities when gait disorder & neuropathy is disabling
• Prognostic:
  • Suggests that the disability will most often be slowly progressive over a period of years.
• Treatment:
  • Indicates directions for treatment in patients with disability
    • Some immunomodulating treatments, such as intravenous immunoglobulin or cyclophosphamide, may produce improvement in weakness, sensory loss or gait disability.
    • Corticosteroids are unlikely to be of benefit, even when neuropathy is demyelinating.