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Central nervous system involvement in multifocal demyelinating neuropathy with persistent conduction block
Author(s) -
Péréon Yann,
Jardel J.,
Guillon B.,
Guihéneuc P.
Publication year - 1994
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.880171106
Subject(s) - medicine , central nervous system , somatosensory evoked potential , somatosensory system , sural nerve , neuritis , electrophysiology , neuroscience , anatomy , psychology , anesthesia , surgery
We report the case of a 27 year‐old man treated for bilateral optic neuritis 5 and 3 years before who within a few months developed sensori‐ motor disorders of the arms and legs Characterized by asymmetric distribution and distal prominence. In addition to sensorimotor defects, which were particularly marked in the left arm and right leg, clinical examination showed nearly generalized areflexia. Electrophysiological studies revealed a rnultifocal neuropathy with persistent distal and proximal conduction blocks associated with a considerable slowing of motor nerve conduction, as well as central nervous system involvement indicated by motor‐, somatosensory‐, and visual‐evoked potentials. CSF analysis showed a mildly elevated protein level; anti‐GM, activity was negative. Sural nerve biopsy revealed onion–bulb‐like formations, and cerebral MRI showed a small, isolated, and aspecific high signal for white matter. First described by Lewis and Sumner in 1982, rnultifocal neuropathy with persistent conduction blocks may be associated with central demyelination. Our case is compared with 3 similar ones in the literature, and the favorable effects of steroid therapy are emphasized. © 1994 John Wiley & Sons, Inc.