When childbirth triggers a hidden neuropathy: hereditary neuropathy with liability to pressure palsies revealed by

Paula Peydro-Lavoie1, Gwendal Le Masson1,2, Stéphane Mathis1,2

  • 1Nerve-Muscle Unit, University Hospital (CHU) of Bordeaux, Bordeaux, France.

Obstetric Medicine
|August 22, 2026
PubMed

Hereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal dominant disorder caused by a PMP22 gene deletion (or mutations), characterized by recurrent, compression-induced mononeuropathies. Postpartum neurological complications are relatively common, but HNPP is rarely considered in their differential diagnosis. We report a case of a 38-year-old woman who developed acute painless bilateral lower limb paralysis following vaginal delivery complicated by prolonged lithotomy positioning and vacuum extraction. Electroneuromyography revealed a demyelinating sensorimotor polyneuropathy with conduction block at the fibular neck, and genetic testing confirmed HNPP. This case underscores the importance of recognizing HNPP as a cause of postpartum paralysis, particularly in patients with a family history of recurrent nerve palsies. Multidisciplinary management, including genetic counseling and tailored obstetric planning for future pregnancies, is essential to optimize outcomes.

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