Evidence Of Peripheral Nervous System Involvement Research Articles

Prevalence of Peripheral Nervous System Involvement in Adult Leukodystrophies (P2-5.031)

<h3>Objective:</h3> na <h3>Background:</h3> Leukodystrophies are genetic, neurodegenerative white matter diseases of the central nervous system (CNS) caused by mutations in various genes, presenting with heterogeneous clinical features and age of onset. It is well established that some leukodystrophies have peripheral nervous system (PNS) involvement, whether demyelinating, axonal or mixed in pathology. However, the prevalence of peripheral neuropathy in adult leukodystrophies is unknown. Early recognition of PNS involvement in these disorders is imperative to enable appropriate management and care of the symptoms. <h3>Design/Methods:</h3> We performed a retrospective review of all adult subjects followed at our two institutions for white matter disease of genetic origin to select patients with evidence of PNS involvement as documented by nerve conduction studies (NCS) and/or electromyography (EMG)For these subjects we collected and analyzed data on sociodemographic status, family history, clinical characteristics, and disease course, nerve conduction studies (NCS), electromyography (EMG), MRI features and genetic testing results. <h3>Results:</h3> From our combined cohorts of 161 adult subjects followed for genetic white matter diseases, we identified 14 patients (8.7%) with documented PNS involvement. A definite genetic diagnosis was established in 5 subjects (3 with adult polyglucosan body disease, 1 with metachromatic leukodystrophy, 1 with POLR3-related disorder) while 9 subjects remained undiagnosed despite extensive genetic investigations. The demographic, clinical, radiological, and electrophysiological data will be presented. <h3>Conclusions:</h3> This is the first study conducted to assess the prevalence of peripheral neuropathy in adult patients with leukodystrophy. In our two independent cohorts, PNS involvement is rare, however, early recognition of the concurrence of CNS and PNS involvement is essential to plan appropriate management of the patients’ symptomatic care and is key as more treatment options are becoming available. <b>Disclosure:</b> Dr. Alsabah has nothing to disclose. Dr. Hasiloglu has nothing to disclose. Dr. Massie has received personal compensation in the range of $500-$4,999 for serving as a Expert consultant with INESS (Quebec Public Health agency). Dr. Massie has received personal compensation in the range of $500-$4,999 for serving as a Lecturer with Amylyx Pharmaceuticals. Dr. Brais has nothing to disclose. Dr. Orthmann Murphy has received research support from Conrad N. Hilton Foundation. Dr. Orthmann Murphy has received research support from Institute for Translational Medicine and Therapeutics’ (ITMAT) Transdisciplinary Program in Translational Medicine and Therapeutics, University of Pennsylvania. The institution of Dr. Orthmann Murphy has received research support from Vigil Neurosciences. The institution of Dr. Orthmann Murphy has received research support from National MS Society. Dr. Orthmann Murphy has received personal compensation in the range of $500-$4,999 for serving as a Invited Speaker with Temple University . Dr. Orthmann Murphy has received personal compensation in the range of $0-$499 for serving as a Consultant with American Neurological Association. Roberta La Piana has nothing to disclose.

Peripheral nervous system involvement in chronic spinal cord injury.

Upper motor neuron disorders are believed to leave the peripheral nervous system (PNS) intact. In this study we examined whether there is evidence of PNS involvement in spinal cord injury (SCI). Twelve subjects with chronic low cervical or thoracic SCI were included prospectively. Needle electromyography was done in 10 different muscles in each subject bilaterally. Nerve conduction studies (NCS) were conducted in the fibular, tibial, and femoral motor and fibular and sural sensory nerves. Half the subjects had widespread abnormal spontaneous activity (SA), and the amount of SA correlated inversely with reflex activity and nerve length. Fibular nerve entrapment across the knee was seen in 6 subjects, and sciatic nerve entrapment was seen in 1. Apart from entrapment neuropathies, NCS changes were found predominantly in motor nerves. The presence of widespread electrophysiologic changes outside entrapment sites indicates that SCI has a significant impact on the entire PNS, affecting the motor part predominantly.