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Lower motor neuron dysfunction in patients with multiple sclerosis.

J M Shefner1, G A Mackin, D M Dawson

  • 1Neurology Division, Brigham and Women's Hospital, Boston, MA 02115.

Muscle & Nerve
|November 1, 1992
PubMed
Summary
This summary is machine-generated.

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Multiple sclerosis (MS) can cause lower motor neuron damage in the hands, leading to muscle atrophy. This central nervous system demyelination may occur at the ventral root exit zone.

Area of Science:

  • Neurology
  • Neuroimmunology
  • Clinical Electrophysiology

Background:

  • Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
  • MS typically affects the brain and spinal cord, leading to a wide range of neurological deficits.
  • Lower motor neuron syndromes are usually associated with peripheral nervous system pathology.

Observation:

  • A patient diagnosed with MS presented with a unilateral lower motor neuron syndrome affecting the hand, confirmed by EMG.
  • A retrospective review identified 12 additional MS patients with asymmetric hand atrophy and evidence of denervation.
  • Electrophysiological studies revealed chronic and ongoing denervation in the hands of 12 out of 13 patients.

Findings:

  • EMG abnormalities in MS patients' hands were primarily attributed to central nervous system lesions, not peripheral nerve damage in most cases.

Related Experiment Videos

  • These findings suggest that MS can directly impact lower motor neurons within the central nervous system.
  • Demyelination near the ventral root exit zone is proposed as the underlying mechanism for these lower motor neuron signs.

    • Implications:

    • This study expands the understanding of MS clinical manifestations beyond typical central nervous system presentations.
    • It highlights the importance of considering MS in patients presenting with unexplained lower motor neuron syndromes, particularly affecting the hands.
    • The findings may prompt further investigation into the specific CNS pathways affected by demyelination in MS and their contribution to motor neuron dysfunction.