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[A severe case of acute autonomic and sensory neuropathy].
Rinsho Shinkeigaku. 1998 Jul; 38(7):663-8.RS

Abstract

Acute autonomic and sensory neuropathy (AASN) is a rare neuropathy characterized by acute autonomic dysfunction and objective sensory disturbances. A 26-year-old pregnant woman with severe autonomic and sensory dysfunction is reported. This patient suddenly developed marked nausea and vomitting in about 2 days after having a sore throat. She then developed signs of autonomic dysfunction including dilated non-reactive pupils, dryness of the eyes and oral mucous membranes, generalized anhidrosis, paralytic ileus, orthostatic hypotension, and continuous tachycardia. She also had severe generalized sensory impairments of all modalities, and all deep tendon reflexes were absent. Sensation was almost totally lost for all modalities below the neck. There was marked pseudoathetosis and sensory ataxia in all extremities. Motor examination was normal. She had inability to urinate. At this time she was 38 weeks pregnant, and when she showed signs of fetal distress, a Caesarean section was performed. Albumino-cytological dissociation was seen in the CSF. Serum noradrenaline was reduced, no sensory nerve action potentials could be elicited, and reduced coefficient of variation of the R-R interval on electrocardiography was observed. Plasma exchange was performed every other day for 3 days for about 3 weeks after the onset of the illness, but no favorable effects. Seven months after the onset, her autonomic dysfunction slightly improved, but there was no recovery from the sensory disturbances. Many symptoms and signs that characterize AASN occurred in this patient, and each was severe. The patient developed SIADH, sleep apnea, personality change, and amenorrhea in the course of the disease. We suggest that AASN patients might have both peripheral and central nervous system manifestations including seizures and personality changes.

Authors+Show Affiliations

Department of Neurology, Nagoya National Hospital.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

jpn

PubMed ID

9868313

Citation

Adachi, H, et al. "[A Severe Case of Acute Autonomic and Sensory Neuropathy]." Rinsho Shinkeigaku = Clinical Neurology, vol. 38, no. 7, 1998, pp. 663-8.
Adachi H, Mukai E, Okuda S, et al. [A severe case of acute autonomic and sensory neuropathy]. Rinsho Shinkeigaku. 1998;38(7):663-8.
Adachi, H., Mukai, E., Okuda, S., & Kawada, T. (1998). [A severe case of acute autonomic and sensory neuropathy]. Rinsho Shinkeigaku = Clinical Neurology, 38(7), 663-8.
Adachi H, et al. [A Severe Case of Acute Autonomic and Sensory Neuropathy]. Rinsho Shinkeigaku. 1998;38(7):663-8. PubMed PMID: 9868313.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [A severe case of acute autonomic and sensory neuropathy]. AU - Adachi,H, AU - Mukai,E, AU - Okuda,S, AU - Kawada,T, PY - 1998/12/30/pubmed PY - 1998/12/30/medline PY - 1998/12/30/entrez SP - 663 EP - 8 JF - Rinsho shinkeigaku = Clinical neurology JO - Rinsho Shinkeigaku VL - 38 IS - 7 N2 - Acute autonomic and sensory neuropathy (AASN) is a rare neuropathy characterized by acute autonomic dysfunction and objective sensory disturbances. A 26-year-old pregnant woman with severe autonomic and sensory dysfunction is reported. This patient suddenly developed marked nausea and vomitting in about 2 days after having a sore throat. She then developed signs of autonomic dysfunction including dilated non-reactive pupils, dryness of the eyes and oral mucous membranes, generalized anhidrosis, paralytic ileus, orthostatic hypotension, and continuous tachycardia. She also had severe generalized sensory impairments of all modalities, and all deep tendon reflexes were absent. Sensation was almost totally lost for all modalities below the neck. There was marked pseudoathetosis and sensory ataxia in all extremities. Motor examination was normal. She had inability to urinate. At this time she was 38 weeks pregnant, and when she showed signs of fetal distress, a Caesarean section was performed. Albumino-cytological dissociation was seen in the CSF. Serum noradrenaline was reduced, no sensory nerve action potentials could be elicited, and reduced coefficient of variation of the R-R interval on electrocardiography was observed. Plasma exchange was performed every other day for 3 days for about 3 weeks after the onset of the illness, but no favorable effects. Seven months after the onset, her autonomic dysfunction slightly improved, but there was no recovery from the sensory disturbances. Many symptoms and signs that characterize AASN occurred in this patient, and each was severe. The patient developed SIADH, sleep apnea, personality change, and amenorrhea in the course of the disease. We suggest that AASN patients might have both peripheral and central nervous system manifestations including seizures and personality changes. SN - 0009-918X UR - https://www.unboundmedicine.com/medline/citation/9868313/[A_severe_case_of_acute_autonomic_and_sensory_neuropathy]_ L2 - https://medlineplus.gov/autonomicnervoussystemdisorders.html DB - PRIME DP - Unbound Medicine ER -