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Peer-reviewedCC BY 4.0Frontiers in Neurology

Electrophysiological profile of polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes syndrome: demyelinating features and lower-limb-predominant response loss

  • Wenli Mei1
  • Changdong Song1
  • Shuyan Feng1
  • Ting Zhao2
  • Jiewen Zhang2
  1. 1Department of Neuroelectrophysiology, Zhengzhou University People's Hospital (Henan Provincial People's Hospital)
  2. 2Department of Neurology, Zhengzhou University People's Hospital (Henan Provincial People's Hospital)
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Abstract

Background and aims: Peripheral neuropathy is a major manifestation of polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes (POEMS) syndrome. We characterized its electrophysiological phenotype and examined whether baseline serum vascular endothelial growth factor (VEGF) reflected concurrent neurological or electrophysiological severity.

Methods: We retrospectively reviewed 32 patients with POEMS syndrome. Clinical findings, baseline serum VEGF, nerve conduction studies, needle electromyography, and median nerve terminal latency index (TLI) were analyzed. Motor conduction findings were additionally assessed according to the 2021 EAN/PNS electrodiagnostic criteria.

Results: Among patients with evaluable motor conduction data, 75.0% fulfilled criteria strongly supportive of demyelination. Peroneal and tibial CMAPs were unrecordable on at least one side in 13/24 patients (54.2%) for each nerve, whereas median and ulnar CMAPs remained recordable in all evaluable patients. Sural SNAPs were unrecordable in 14/24 patients (58.3%). Active denervation was identified in 23/24 patients (95.8%) with available needle electromyography records, with lower-limb involvement in 22/23 (95.7%) of those showing active denervation. Median nerve TLI was >0.38 in 13/22 patients (59.1%). Ankle dorsiflexion strength showed a moderate positive correlation with peroneal CMAP amplitude ( ρ = 0.537, p = 0.015), and disease duration was inversely correlated with sural SNAP amplitude ( ρ = −0.461, p = 0.023). Other clinical–electrophysiological associations were not significant. Baseline serum VEGF was not consistently associated with cross-sectional neurological or electrophysiological severity.

Interpretation: In this POEMS cohort, demyelinating abnormalities coexisted with lower-limb-predominant motor and sensory response loss. Frequent active denervation supports concomitant motor axonal involvement. Median nerve TLI provided an additional descriptive feature, whereas a single baseline VEGF measurement may not closely reflect concurrent peripheral nerve dysfunction.

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Cite

BibTeXRIS
BibTeX
@article{mei2026electrophysiological,
  title = {{Electrophysiological profile of polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes syndrome: demyelinating features and lower-limb-predominant response loss}},
  author = {Wenli Mei and Changdong Song and Shuyan Feng and Ting Zhao and Jiewen Zhang},
  journal = {Frontiers in Neurology},
  year = {2026},
  month = nov,
  doi = {10.3389/fneur.2026.1999633},
  url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1999633/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Electrophysiological profile of polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes syndrome: demyelinating features and lower-limb-predominant response loss
AU  - Wenli Mei
AU  - Changdong Song
AU  - Shuyan Feng
AU  - Ting Zhao
AU  - Jiewen Zhang
PY  - 2026
DA  - 2026/11/03
JO  - Frontiers in Neurology
DO  - 10.3389/fneur.2026.1999633
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2026.1999633/full
AB  - Background and aims: Peripheral neuropathy is a major manifestation of polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes (POEMS) syndrome. We characterized its electrophysiological phenotype and examined whether baseline serum vascular endothelial growth factor (VEGF) reflected concurrent neurological or electrophysiological severity.  Methods: We retrospectively reviewed 32 patients with POEMS syndrome. Clinical findings, baseline serum VEGF, nerve conduction studies, needle electromyography, and median nerve terminal latency index (TLI) were analyzed. Motor conduction findings were additionally assessed according to the 2021 EAN/PNS electrodiagnostic criteria.  Results: Among patients with evaluable motor conduction data, 75.0% fulfilled criteria strongly supportive of demyelination. Peroneal and tibial CMAPs were unrecordable on at least one side in 13/24 patients (54.2%) for each nerve, whereas median and ulnar CMAPs remained recordable in all evaluable patients. Sural SNAPs were unrecordable in 14/24 patients (58.3%). Active denervation was identified in 23/24 patients (95.8%) with available needle electromyography records, with lower-limb involvement in 22/23 (95.7%) of those showing active denervation. Median nerve TLI was >0.38 in 13/22 patients (59.1%). Ankle dorsiflexion strength showed a moderate positive correlation with peroneal CMAP amplitude ( ρ = 0.537, p = 0.015), and disease duration was inversely correlated with sural SNAP amplitude ( ρ = −0.461, p = 0.023). Other clinical–electrophysiological associations were not significant. Baseline serum VEGF was not consistently associated with cross-sectional neurological or electrophysiological severity.  Interpretation: In this POEMS cohort, demyelinating abnormalities coexisted with lower-limb-predominant motor and sensory response loss. Frequent active denervation supports concomitant motor axonal involvement. Median nerve TLI provided an additional descriptive feature, whereas a single baseline VEGF measurement may not closely reflect concurrent peripheral nerve dysfunction.
SN  - 1664-2295
ER  -