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Published on: October 7, 2021
Sural nerve pathology in ALS patients: a single-centre experience
Marco Luigetti1, Amelia Conte, Alessandra Del Grande
1Institute of Neurology, Catholic University of Sacred Heart, Largo F. Vito 1, 00168 Rome, Italy. mluigetti@gmail.com
Summary
Sensory nerve involvement, including axonal loss, can occur in patients with amyotrophic lateral sclerosis (ALS). This finding necessitates careful diagnosis but does not rule out ALS.
Area of Science:
- Neurology
- Neuroscience
- Pathology
Background:
- Amyotrophic lateral sclerosis (ALS) is characterized by motor neuron degeneration.
- Sensory system involvement is traditionally not considered a hallmark of ALS.
Purpose of the Study:
- To investigate the presence and nature of sensory nerve involvement in a cohort of amyotrophic lateral sclerosis (ALS) patients.
- To evaluate the diagnostic implications of sensory nerve findings in ALS.
Main Methods:
- Retrospective review of 17 sural nerve biopsies from ALS patients over 23 years.
- Pathological examination of nerve tissue.
- Clinical correlation and genetic evaluation in specific cases.
Main Results:
- Over two-thirds of sural nerve biopsies showed axonal loss.
- One case presented with findings suggestive of inherited neuropathy.
- Another case exhibited features mimicking inflammatory demyelinating neuropathy, yet clinically progressed as ALS.
Conclusions:
- Sensory nerve involvement, particularly axonal loss, is observed in a significant proportion of ALS patients.
- These findings highlight the importance of considering differential diagnoses.
- The presence of sensory abnormalities does not exclude an ALS diagnosis.
