Morphometric Study on Changes in Sural Nerves and Comparison with Clinical Manifestations in Familial Amyloidosis

  • Akira Nakadai
  • Norinao Hanyu
  • Nobuo Yanagisawa


A morphometric study was made on 23 sural nerves from 19 patients (16 specimens taken by biopsy and 7 by autopsy, overlapping in 4 cases) with familial amylodosis in Nagano Prefecture. Densities of myelinated and unmy-elinated fibers (DMF and DUF) were measured by light-and electron-microscopy. The presence or degree of certain neurological signs at the time of tissue removal was separately evaluated, and these were found to correspond with the morphologic changes. (1) Cases with apparent dissociated sensory disturbance disclosed a higher ratio of large DMF to total DMF than cases without the sign. (2) Cases with deep sensory disturbance, with moderate to severe muscle wasting or with no achilles tendon reflex showed lower values for large and small DMF than cases without these signs. (3) Cases with cutaneous bullae showed lower values for DUF and small DMF than cases without the sign. From these results, the presence or severity of certain clinical signs was considered to correspond well to the degeneration of relevant fibers.


Sural Nerve Myelinated Fiber Sensory Disturbance Touch Sensation Tissue Removal 
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  1. 1.
    C. Andrade, A peculiar form of peripheral neuropathy, Brain, 75:408 (1952).CrossRefGoogle Scholar
  2. 2.
    P. J. Dyck, and E. H. Lambert, Dissociated sensation in amyloidosis, Arch Neurol, 20:490 (1969).CrossRefGoogle Scholar
  3. 3.
    P. K. Thomas, and R. H. M. King, Peripheral nerve changes in amyloid neuropathy, Brain, 97:395 (1974).CrossRefGoogle Scholar
  4. 4.
    A. Coimbra, and C. Andrade, Familial amyloid polyneuropathy. An electron microscope study of peripheral nerve in five cases, Brain, 94:199, and 207, (1971).CrossRefGoogle Scholar
  5. 5.
    L. M. A. Danieles, and C. Worthingham, Muscle test, in: Muscle testing, Saunders, Philadelphia, London, and Toronto (1972).Google Scholar
  6. 6.
    W. F. Collins, F. E. Nulsen, and C. T. Randt, Relation of peripheral nerve fiber size and sensation in man, Arch Neurol, 3:381 (1960).CrossRefGoogle Scholar
  7. 7.
    W. F. Ganong, Excitable tissue: Nerve, in: Review of medical physiology, Lange Medical Publications, California (1975).Google Scholar
  8. 8.
    A. Nakadai, N. Hanyu, S. Ikeda, and N. Yanagisawa, Modes of nerve fiber degeneration in the sural nerve with familial amyloidosis, in preparation.Google Scholar
  9. 9.
    M. Yazawa, N. Hanyu, J. Yoshioka, A. Nakadai, and N. Yanagisawa, Bullous lesions in familial amyloid polyneuropathy and treatment with L-threo-3,4,-Dihydroxyphenylserine, in preparation.Google Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Akira Nakadai
    • 1
  • Norinao Hanyu
    • 1
  • Nobuo Yanagisawa
    • 1
  1. 1.Department of Medicine (Neurology)Shinshu University School of MedicineMatsumoto 390Japan

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