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Peripheral Nervous System Involvement (peripheral + nervous_system_involvement)
Selected AbstractsPeripheral nervous system involvement as presenting symptom of systemic B-cell lymphomaJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2004C Casellato Peripheral nervous system involvement has been reported in systemic B or T cell lymphoma and may result from intraneural localization of lymphoma resulting in meningo-radiculopathy or mononeuropathies, or manifest as a sensory-motor polyneuropathy sometimes mimicking chronic inflammatory demyelinating polyneuropathy. We report two patients with a previously unknown NHL presenting in both with a stepwise progressive asymmetric multiradiculoneuropathy initially misdiagnosed as inflammatory radiculopathy. A 58-year-old man presented with a 2 year history of stepwise progressive peroneal sensory loss, impotence, and lower limb painful asymmetric neuropathy. Lumbosacral MRI was normal. Electrophysiological studies were consistent with an axonal multiradiculoneuropathy while CSF examinations repeatedly showed increased protein levels (80,91 mg/dl) with slightly increased white cells (<10 mm3) but no malignant cell. The patient repeatedly failed to respond to steroids although he consistently deteriorated at their suspension. An MRI performed 2 years later when multiple cranial nerve palsies appeared showed bilateral T1 and T2 hyperintensities in the brain and cervical spinal cord. An extensive investigation for neoplasm was negative. The patient died from an intracranial hemorrhage during anticoagulant therapy for deep vein thrombosis. Autoptic studies revealed a widespread non-Hodgkin's type B lymphoma with massive systemic and neural involvement including cauda equina and spinal cord. A 54-year-old man presented with a 1 year history of impotence, urinary incontinence, progressive asymmetric painful distal sensorimotor impairment at four limbs and prominent weight loss. Four previous CSF examinations revealed increased protein levels (80,100 mg/dl), and slightly but inconsistently increased white cells (1,11/mm3) but no malinant cells. Steroids were repeatedly ineffective although the patient consistently deteriorated whenever steroids were discontinued. On admission electrophysiological studies showed an axonal asymmetric polyradiculoneuropathy. Brain and spinal MRI was normal while bone marrow biopsy and aspiration disclosed a B cell lymphoma. [source] Subacute inflammatory polyradiculopathy associated with Sjögren's syndromeMUSCLE AND NERVE, Issue 6 2009Andrea Rigamonti MD Abstract Peripheral nervous system involvement is common in Sjögren's syndrome (SS); however, polyradiculopathy has been reported rarely in association with SS, and predominantly chronic forms have been described. We describe a patient with clinical, cerebrospinal fluid, neurophysiological, and neuroradiological evidence of subacute inflammatory polyradiculopathy in whom Sjögren's syndrome was diagnosed after the onset of neurological symptoms. Our case suggests that SS should be included in the differential diagnosis of subacute inflammatory polyradiculopathy. Muscle Nerve, 2009 [source] Axonal Neuropathy Associated With Cold Agglutinins: A Vasculitic-Ischaemic NeuropathyJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 1 2001G Bezzi Cold agglutinin (CA) disease is an autoimmune hemolytic process characterized by chronic anemia, hemoglobinuria, cold induced rash, and acrocyanosis of exposed body parts. Although few cases of peripheral neuropathies have been observed in patients with CA, the mechanism of peripheral nervous system involvement is still uncertain. However, similar to other neuropathies due to IgM paraproteinaemia, such as anti-myelin associated glycoprotein, or anti-acidic glycolipid sulphate-3-glucuronyl paragloboside, the direct effect of the antibody on nerve constituents is considered the pathogenetic mechanism causing the demyelinating neuropathy. We report a patient with CA and sensorimotor peripheral neuropathy with electrophysiological and histological findings of a severe acute axonal neuropathy. Pathological findings show vascular damage in the nerve, suggesting a major role for ischaemic/vasculitic pathogenetic mechanism of the peripheral neuropathy in CA. [source] | ||||||||||