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Multifocal demyelinating neuropathy with persistent conduction block

R A Lewis, A J Sumner, M J Brown

    Neurology
    |September 1, 1982
    PubMed
    Summary
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    Chronic multifocal demyelinating neuropathy, a peripheral nervous system disorder, presents with nerve conduction blocks. Corticosteroid treatment showed improvement in some patients.

    Area of Science:

    • Neurology
    • Neuroimmunology

    Background:

    • Chronic acquired demyelinating polyneuropathy (CADP) encompasses various forms of immune-mediated peripheral nerve damage.
    • Understanding variants of CADP is crucial for accurate diagnosis and effective treatment.

    Observation:

    • Five patients presented with chronic asymmetric sensorimotor neuropathy, predominantly affecting upper extremities with focal nerve involvement.
    • Electrophysiologic studies revealed persistent multifocal conduction block, confirming the diagnosis.
    • Nerve biopsies showed demyelinating-remyelinating changes and fiber loss.

    Findings:

    • Two patients experienced acute optic neuritis, suggesting potential central nervous system involvement.
    • Patients treated with corticosteroids demonstrated clinical improvement.

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  • Untreated patients exhibited static deficits or disease progression.

    • Implications:

    • This condition appears to be a distinct variant of chronic acquired demyelinating polyneuropathy.
    • The findings suggest an immunologically mediated etiology.
    • Recognition of this neuropathy variant may guide therapeutic strategies and improve patient outcomes.