Selective Vulnerability of Nerve Demyelination in Chronic Acquired Multifocal Polyneuropathy

Yangtai Guan

doi:10.26717/bjstr.2019.18.003213

Abstract

The pathological features of peripheral nerve myelin lesion are known as diffuse and focal demyelination.

Highlights

Multifocal motor neuropathy (MMN), Lewis-Sumner syndrome (LSS) and many of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are representatives of acquired multifocal polyneuropathy and characterized by conduction block (CB)
The LSS and CIDP diagnoses were based on the 2010 European Federation of Neurological Societies (EFNS)/Peripheral Nerve Society (PNS) guideline on CIDP [12], and the MMN diagnose was based on the 2010 EFNS/PNS guideline on MMN [13]
Pure upper limb onset and sensory involvement were less probable in CIDP with CB (CIDP-CB) group compared to MMN group (p

Summary

Introduction

Multifocal motor neuropathy (MMN), Lewis-Sumner syndrome (LSS) and many of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are representatives of acquired multifocal polyneuropathy and characterized by conduction block (CB). Multifocal motor neuropathy (MMN) and Lewis-Sumner syndrome (LSS) are the most representative chronic acquired focal neuropathies, while many of the classic chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) presents with CB [5]. Distinct from common peripheral neuropathies, the motor impairments in these focal neuropathies are clinically uneven, i.e., non-length dependent and asymmetric [6,7]. Their limb onset selectivity is well-known [8], not efficient in reciprocal differentiation. In this study, by using of a bunch of well-established electrophysiological indicators, e.g., distal motor latency (DML), terminal latency index (TLI), F-wave latency and nerve conduction velocity (NCV) as well as CB, we aimed to investigate the selective vulnerability and the demyelinating pattern of nerves and segments in patients with MMN, LSS and CIDP with CB (CIDP-CB)

Methods

Results

Discussion

Conclusion