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Acta Neuropathologica

, Volume 104, Issue 2, pp 179–187 | Cite as

Polyneuropathy in neurofibromatosis 2: clinical findings, molecular genetics and neuropathological alterations in sural nerve biopsy specimens

  • Christian Hagel
  • Matthias Lindenau
  • Katrin Lamszus
  • Lan Kluwe
  • Dimitrios Stavrou
  • Victor-Felix Mautner
Regular paper

Abstract.

Neurofibromatosis 2 (NF2) is an autosomal dominant disease characterised by development of tumours in the central and peripheral nervous system. Some NF2 patients develop acro-distal sensory motor polyneuropathy that can hardly be explained by the tumour burden alone. In the present study eight sural nerve biopsy specimens from seven NF2 patients suffering from polyneuropathy were investigated, data including clinical course of the disease, electrophysiological findings, teased fibre preparations, histopathological, morphometric, immunohistochemical, electron microscopic and molecular genetic findings. All patients suffered from distal symmetric reflex loss, symmetrical stocking-like hypalgesia and hypesthesia and loss of vibration sense later followed by a slowly progressive distal muscle atrophy and paresis. Sural nerve biopsy specimens revealed a pathological reduction of nerve fibre density correlating with age. In addition, diffuse proliferation of Schwann cells was observed in five of eight biopsies, and small endoneurial tumourlets of schwannomas and perineuriomas were found in two of eight and one of eight samples, respectively. Ki-67 labelling revealed a slight endoneurial proliferative activity in three cases. Schwann cell onion bulbs with or without central myelinated axon were seen in two cases. The findings suggest an axonopathy of multifactorial origin resulting not only from gross tumour growth but, in addition, from small endoneurial tumourlets, diffuse proliferation of Schwann cells and proliferation of perineurial cells.

Axonopathy Neurofibromatosis 2 Polyneuropathy Sural nerve biopsy 

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Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • Christian Hagel
    • 1
  • Matthias Lindenau
    • 3
  • Katrin Lamszus
    • 1
  • Lan Kluwe
    • 2
  • Dimitrios Stavrou
    • 1
  • Victor-Felix Mautner
    • 3
  1. 1.Department of Neuropathology, University Clinic Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, GermanyGermany
  2. 2.Laboratory of Brain Tumour Biology Clinic of Neurosurgery, University Clinic Hamburg-Eppendorf, Hamburg, GermanyGermany
  3. 3.Department of Neurology, Clinicum Nord Ochsenzoll General Hospital, Hamburg, GermanyGermany

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