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Sensory nerve pathology in multifocal motor neuropathy.
Ann Neurol. 1996 Mar; 39(3):319-25.AN

Abstract

The nosological status of multifocal motor neuropathy remains controversial. The clinical and electrodiagnostic hallmarks suggest selective motor fiber involvement. In this study, we asked to what extent sensory nerves might be involved pathologically in multifocal motor neuropathy. Examination of sensory nerve biopsy specimens from 11 patients did reveal pathological findings in all, but they were very mild. An increased number of thinly myelinated, large-caliber fibers was the unifying feature common to each specimen. By electron microscopy, each biopsy specimen had thinly myelinated fibers surrounded by minor onion bulbs. Active demyelination, though scant, was seen in 3 nerves. Myelinated fiber density was normal. Subperineurial edema and inflammation were not present. We conclude that multifocal motor neuropathy is not an exclusively motor abnormality, although it appears to be so clinically and electrophysiologically. The frequent, albeit mild, pathological abnormalities in sensory fibers suggest that the demyelinating pathophysiology also affects sensory fibers, but to a lesser degree than motor fibers. Some investigators maintain that multifocal motor neuropathy is within the spectrum of chronic inflammatory demyelinating polyneuropathy. The very mild degree of sensory fiber involvement, the absence of inflammation or edema, and the distinctive clinical features support the concept of multifocal motor neuropathy as distinct from chronic inflammatory demyelinating polyneuropathy.

Authors+Show Affiliations

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287-7519, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8602750

Citation

Corse, A M., et al. "Sensory Nerve Pathology in Multifocal Motor Neuropathy." Annals of Neurology, vol. 39, no. 3, 1996, pp. 319-25.
Corse AM, Chaudhry V, Crawford TO, et al. Sensory nerve pathology in multifocal motor neuropathy. Ann Neurol. 1996;39(3):319-25.
Corse, A. M., Chaudhry, V., Crawford, T. O., Cornblath, D. R., Kuncl, R. W., & Griffin, J. W. (1996). Sensory nerve pathology in multifocal motor neuropathy. Annals of Neurology, 39(3), 319-25.
Corse AM, et al. Sensory Nerve Pathology in Multifocal Motor Neuropathy. Ann Neurol. 1996;39(3):319-25. PubMed PMID: 8602750.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sensory nerve pathology in multifocal motor neuropathy. AU - Corse,A M, AU - Chaudhry,V, AU - Crawford,T O, AU - Cornblath,D R, AU - Kuncl,R W, AU - Griffin,J W, PY - 1996/3/1/pubmed PY - 1996/3/1/medline PY - 1996/3/1/entrez SP - 319 EP - 25 JF - Annals of neurology JO - Ann. Neurol. VL - 39 IS - 3 N2 - The nosological status of multifocal motor neuropathy remains controversial. The clinical and electrodiagnostic hallmarks suggest selective motor fiber involvement. In this study, we asked to what extent sensory nerves might be involved pathologically in multifocal motor neuropathy. Examination of sensory nerve biopsy specimens from 11 patients did reveal pathological findings in all, but they were very mild. An increased number of thinly myelinated, large-caliber fibers was the unifying feature common to each specimen. By electron microscopy, each biopsy specimen had thinly myelinated fibers surrounded by minor onion bulbs. Active demyelination, though scant, was seen in 3 nerves. Myelinated fiber density was normal. Subperineurial edema and inflammation were not present. We conclude that multifocal motor neuropathy is not an exclusively motor abnormality, although it appears to be so clinically and electrophysiologically. The frequent, albeit mild, pathological abnormalities in sensory fibers suggest that the demyelinating pathophysiology also affects sensory fibers, but to a lesser degree than motor fibers. Some investigators maintain that multifocal motor neuropathy is within the spectrum of chronic inflammatory demyelinating polyneuropathy. The very mild degree of sensory fiber involvement, the absence of inflammation or edema, and the distinctive clinical features support the concept of multifocal motor neuropathy as distinct from chronic inflammatory demyelinating polyneuropathy. SN - 0364-5134 UR - https://www.unboundmedicine.com/medline/citation/8602750/Sensory_nerve_pathology_in_multifocal_motor_neuropathy_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0364-5134&date=1996&volume=39&issue=3&spage=319 DB - PRIME DP - Unbound Medicine ER -