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Multifocal motor neuropathy presenting as ophthalmoplegia
C E Pringle1, J Belden, J E Veitch
1The University of Ottawa, Division of Neurology, Ontario, Canada.
Muscle & Nerve
|March 1, 1997
Summary
Multifocal motor neuropathy (MMN) can rarely cause eye muscle and cranial nerve palsies. This case highlights overlapping features between MMN and chronic inflammatory demyelinating polyradioneuropathy (CIDP).
Area of Science:
- Neurology
- Neuroimmunology
Background:
- Multifocal motor neuropathy (MMN) is a rare autoimmune disorder characterized by progressive, asymmetric limb weakness.
- Diagnosis typically relies on electrophysiological evidence of conduction block in motor nerves.
Observation:
- A 45-year-old man presented with ophthalmoplegia and multiple cranial nerve palsies, alongside bibrachial paresis.
- Investigations showed proximal conduction block, primarily affecting motor fibers, with sensory fibers seemingly spared.
- Other potential causes for the neurological deficits were excluded.
Findings:
- The patient was diagnosed with multifocal motor neuropathy with conduction block (MMN).
- Electrophysiological findings indicated a very proximal conduction block, potentially at the spinal roots.
- The patient showed a positive response to cyclophosphamide treatment.
Implications:
- This case expands the known clinical spectrum of MMN, demonstrating its rare association with ophthalmoparesis.
- It underscores the potential for overlapping clinical and electrophysiological features between MMN and chronic inflammatory demyelinating polyradioneuropathy (CIDP).
- Highlights the importance of considering MMN in patients with unusual cranial nerve and ocular motor involvement.