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Sensory Neuropathies pp 91–104Cite as

Spectrum of acquired sensory neuropathy: Clinical, electrodiagnostic, and pathologic studies

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Summary

Clinical review of 33 patients with acquired predominantly sensory neuropathy defined by electrodiagnostic and clinical findings showed a igh female predominance (76%). Characteristically the neuropathy was asymmetric at onset (73%), evolved in a subacute (45%) or chronic fashion (40%), and started with upper extremity pain (67%). Ataxia (52%) and Adie’s pupils (18%) also seemed characteristic of this neuropathy. In 16 patients (48%) underlying causes such as cancer (12%), connective tissue disorders (9%), drug-induced (9%), and others (18%) were identified, but no etiology was determined in the rest of the patients (52%). Nonspecific serum and CSF immunological abnormalities were common (55%), suggesting underlying immune-mediated disorders in some patients. Electrodiagnostic studies suggested that sensory neuropathy was mainly an axon-loss disorder. The upper extremity preponderance and the asymmetric involvement were confirmed electrodiagnostically in some patients. Nerve biopsies showed scattered acute axonal degeneration and severe loss of myelinated fibers but well-preserved unmyelinated fibers. Corticosteroid or other immunotherapy was not beneficial in most patients treated. In all but two patients, the neuropathy was either progressive or unimproved over an average of 6.2 years of follow-up.

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References

  1. Alexander EL, Provost TT, Stevens MB, Alexander GE (1982) Neurological complications of primary Sjögren’s syndrome. Medicine 61: 247–257

    Article  PubMed  CAS  Google Scholar 

  2. Anderson NE, Rosenbum MK, Posner JB (1988) Paraneoplastic cerebellar degeneration: Clinical-immunological correlations. Ann Neurol 24: 559–567

    Article  PubMed  CAS  Google Scholar 

  3. Asbury AK (1987) Sensory neuropathy. Sem Neurol 7: 58–66

    Article  CAS  Google Scholar 

  4. Binder HJ, Solitare GB, Spiro HM (1967) Neuromuscular disease in patients with steatorrhea. Gut 8: 605–611

    Article  PubMed  CAS  Google Scholar 

  5. Castleman B, Kibbie B (1960) Case records of the Massachusetts General Hospital. N Engl J Med 263: 804–808

    Article  Google Scholar 

  6. Chad D, Shoukimas GM, Bradley WG, Bosch EP, Shahani BT, Young RR (1981) Peripheral nerve unmyelinated axons following lumbar sympathectomy. Ann Neurol 10: 486–488

    Article  PubMed  CAS  Google Scholar 

  7. Cornblath DR, McArthur JC (1988) Predominantly sensory neuropathy in patients with AIDS and AIDS-related complex. Neurology 38: 794–796

    Article  PubMed  CAS  Google Scholar 

  8. Croft PB, Henson RA, Ulrich H, Wilkinson PC (1965) Sensory neuropathy with bronchial carcinoma: A study of four cases showing serological abnormalities. Brain 88: 501–514

    Article  PubMed  CAS  Google Scholar 

  9. Croft PB, Urich H, Wilkinson PC (1967) Peripheral neuropathy of the sensorimotor type associated with malignant disease. Brain 90: 31–66

    Article  PubMed  CAS  Google Scholar 

  10. Dalakas M (1985) Chronic progressive sensory ataxia. Studies in 15 patients with “idiopathic” large-fiber sensory neuropathy. Neurology 15 [Suppl 1]: 76

    Google Scholar 

  11. Dalakas MC, Pezeshkpour GH (1988) Neuromuscular diseases associated with human immunodeficiency virus infection. Ann Neurol 23: S 38–48

    Article  Google Scholar 

  12. Denny-Brown D (1951) Hereditary sensory radicular neuropathy. J Neurol Neurosurg Psychiatry 14: 237–252

    Article  PubMed  CAS  Google Scholar 

  13. Dick DJ, Harris JB, Falkous G, Foster JB, Xuereb JH (1988) Neuronal anti-nuclear antibody in paraneoplastic sensory neuronopathy. J Neurol Sci 85: 1–8

    Article  PubMed  CAS  Google Scholar 

  14. Dyck PJ, Lambert EH, Nichols PC (1971) Quantitative measurement of sensation related to compound action potential and number and sizes of myelinated and unmyelinated fibers of sural nerve in health, Friedreich’s ataxia, hereditary sensory neuropathy, and tabes dorsalis. In: Remond A (ed) Handbook of electroencephalography and clinical neurophysiology. Elsevier: Amsterdam, pp 83–118

    Google Scholar 

  15. Dyck PJ (1984) Neuronal atrophy and degeneration predominantly affecting peripheral sensory and autonomic neurons. In: Dyck PJ, Thomas PK, Lambert EH, Bunge R (eds) Peripheral neuropathy, 2nd edn. Saunders: Philadelphia, pp 1557–1599

    Google Scholar 

  16. Egger J, Lake BD, Wilson J (1981) Mitochondrial cytopathy. A multisystem disorder with ragged red fibers on muscle biopsy. Arch Dis Child 56: 741–752

    Article  PubMed  CAS  Google Scholar 

  17. Graus F, Cordon-Cardo C, Posner JB (1985) Neuronal antinuclear antibody in sensory neuronopathy from lung cancer. Neurology 35: 638–643

    Article  Google Scholar 

  18. Gray KW, Woolf AL, Wright EA (1955) Two cases of primary sensory neuropathy associated with carcinoma. Guy Hosp Rep 104: 157–176

    CAS  Google Scholar 

  19. Heathfield KWG, Williams JRB (1955) Peripheral neuropathy and myopathy associated with bronchogenic carcinoma. Brain 77: 122–137

    Article  Google Scholar 

  20. Henson RA, Hoffman HL, Urich H (1956) Encephalomyelitis with carcinoma. Brain 88: 449–464

    Article  Google Scholar 

  21. Horwich MS, Cho L, Porro RS, Posner JB (1977) Subacute sensory neuropathy: a remote effect of carcinoma. Ann Neurol 2: 7–19

    Article  PubMed  CAS  Google Scholar 

  22. Kaufman MD, Hopkins LC, Hurwitz BJ (1981) Progressive sensory neuropathy in patients without carcinoma: A disorder with distinctive clinical and electrophysiological findings. Ann Neurol 9: 237–242

    Article  PubMed  CAS  Google Scholar 

  23. Kilroy A, Schaffner W, Fleet WF, Lefkowitz LB, Karzon DT, Fenichel GM (1970) Two syndromes following rubella immunization. J Am Med Assoc 214: 2287–2292

    Article  CAS  Google Scholar 

  24. McCombe PA, McLeod JG (1984) The peripheral neuropathy of vitamin B12 deficiency. J Neurol Sci 66: 117–126

    Article  PubMed  CAS  Google Scholar 

  25. Miller RG, Nielson SL, Sumner AJ (1976) Hereditary sensory neuropathy and tonic pupils. Neurology 26: 931–935

    Article  PubMed  CAS  Google Scholar 

  26. Mitsumoto H, Gambetti P (1986) Slow axonal transport in Wobbler motor neuron disease. Ann Neurol 19: 36–43

    Article  PubMed  CAS  Google Scholar 

  27. Murdoch WR, Walker RS (1957) Carcinoma of the lung presenting as ataxia. Scot Med J 2: 39–41

    PubMed  CAS  Google Scholar 

  28. Nukada H, Pollock M, Haas LF (1982) The clinical spectrum and morphology of type II hereditary sensory neuropathy. Brain 105: 647–666

    Article  PubMed  Google Scholar 

  29. Ochoa J, Mair WG (1969) The normal sural nerve in man. I. Ultrastructure and number of fibers and cells. Acta Neuropathol 13: 197–216

    Article  PubMed  CAS  Google Scholar 

  30. Ohta M, Ellefson RD, Lambert EH, Dyck PJ (1973) Hereditary sensory neuropathy, type II. Arch Neurol 29: 23–37

    Article  Google Scholar 

  31. Ohnishi A, Ogawa M (1986) Preferential loss of large lumbar primary sensory neurons in carcinomatous sensory neuropathy. Ann Neurol 20: 102–104

    Article  PubMed  CAS  Google Scholar 

  32. Oishi T, Inoue N, Shiraishi S, Uozume T, Murai Y (1984) Mixed connective tissue disease with Adie’s syndrome and mononeuritis multiplex including trigeminal neuropathy. Clin Neurol (Tokyo) 24: 941–944

    CAS  Google Scholar 

  33. Salanga V, Streib E (1978) Adie’s pupil and acquired predominantly sensory peripheral neuropathy. Electroencephal Clin Neurophysiol 45: 23

    Google Scholar 

  34. Schaumberg H, Kaplan J, Windebank A, Vick N, Rasmus S, Pleasure D, Brown MJ (1983) Sensory neuropathy from pyridoxine abuse. A new megavitamin syndrome. N Engl J Med 309: 445–448

    Article  Google Scholar 

  35. Staal A, Mechelse K (1978) Hereditary sensory neuropathy: a new type. Hum Genet 42: 115–118

    Article  PubMed  CAS  Google Scholar 

  36. Sterman AB, Schaumberg HH, Asbury AK (1980) The acute sensory neuropathy syndrome: a distinct clinical entity. Ann Neurol 7: 354–358

    Article  PubMed  CAS  Google Scholar 

  37. Thomas PK (1984) Clinical features and differential diagnosis. In: Dyck PJ, Thomas PK, Lambert EH, Bunge R (eds) Peripheral neuropathy, 2nd edn. Saunders: Philadelphia, pp 1169–1190

    Google Scholar 

  38. Thompson SW, Davis LE, Kornfeld M, Hilgers RD, Standefer JC (1982) Cisplatinum neuropathy: clinical, electrophysiologic, morphologic, and toxicologic studies. Neurology 32: A133–134

    Article  Google Scholar 

  39. Uldry PA, Steck AJ, Regli F (1984) Manifestations neurologiques des gammopathies monoclonales. Schweiz Med Wochenschr 114: 1678–1685

    PubMed  CAS  Google Scholar 

  40. Whitaker JN, Falchuck ZM, Engel WK, Blaese RM, Strober W (1974) Hereditary sensory neuropathy. Arch Neurol 30: 359–371

    Article  PubMed  CAS  Google Scholar 

  41. Windebank AJ, Blexrud MD, Dyck PJ, Daube JR, Karnes JL (1990) The syndrome of acute sensory neuropathy: clinical features and electrphysiologic and pathologic changes. Neurology 40: 584–591

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

    H. Mitsumoto & A. J. Wilbourn

Authors
  1. H. Mitsumoto
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  2. A. J. Wilbourn
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Editors and Affiliations

  1. Department of Neurology, University of Pennsylvania Medical Center, Philadelphia, USA

    Arthur K. Asbury M.D.

  2. Klinisches Institut für Neurologie, AKH, Wien, Austria

    Herbert Budka

  3. Neurologischen Abteilung des Wilhelminenspitals, Wien, Austria

    Elfriede Sluga (em. Vorstand) (em. Vorstand)

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© 1995 Springer-Verlag Wien

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Mitsumoto, H., Wilbourn, A.J. (1995). Spectrum of acquired sensory neuropathy: Clinical, electrodiagnostic, and pathologic studies. In: Asbury, A.K., Budka, H., Sluga, E. (eds) Sensory Neuropathies. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6595-9_10

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  • DOI: https://doi.org/10.1007/978-3-7091-6595-9_10

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-82642-3

  • Online ISBN: 978-3-7091-6595-9

  • eBook Packages: Springer Book Archive

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