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Published on: March 4, 2014
Clinical Reasoning: A 39-Year-Old Man With Asymmetric Distal Weakness and Loss of Sensitivity
Valentin Loser1, Gabriela Blanchard2, Emmanuella Guenova2
1From the Nerve-Muscle Unit (V.L., M.T., A.V.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; and Dermatology Service (G.B., E.G.), Lausanne University Hospital and University of Lausanne, Switzerland. valentin.loser@chuv.ch.
Abstract:
A 39-year-old man presented with an asymmetric distal weakness and loss of sensitivity sequentially affecting both lower extremities and the left upper limb. Nerve conduction studies showed a multifocal sensory and motor axonal neuropathy, and a pseudo-conduction block of the right fibular nerve, the whole being consistent with a mononeuropathy multiplex. An uncommon etiology was found after an extensive workup. Axonal loss was severe, with only partial response to treatment with corticosteroids and IV immunoglobulins.
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