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NEUROLOGY 1990;40:584
© 1990 American Academy of Neurology

The syndrome of acute sensory neuropathy

Clinical features and electrophysiologic and pathologic changes

A. J. Windebank, MD, M. D. Blexrud, P. J. Dyck, MD, J. R. Daube, MD and J. L. Karnes, MS

Peripheral Nerve Center Research Laboratory and the Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, MN.

We followed 42 patients with clinically defined pure sensory neuropathy of acute or subacute onset for 2 to 35 years. The symptoms began in the upper limbs in 23 patients, in the lower limbs in 13, symmetrically in all 4 limbs in 4, and the face was 1st affected in 2. For 19 patients, the symptoms began asymmetrically. Electrophysiologic testing typically showed absence of sensory potentials. Spinal fluid was usually acellular with a normal protein level. Sural nerve biopsy in 22 patients showed loss of large myelinated fibers and axonal atrophy without inflammation. Six of the patients died: 4 of unrelated causes and 2 of subdural hemorrhages. Only 2 patients had severe functional impairment. Twenty-two had significant sensory deficit but were able to carry out most of their usual activities. In 8, the symptoms had resolved completely. The acute, often focal onset suggests an immune-mediated or vascular process at the level of the posterior root or dorsal root ganglion.

Address correspondence and reprint requests to Dr. A.J. Windebank, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Supported in part by grants from NIH (NS14304) and Mayo funds.

Presented in part at the 41st annual meeting of the American Academy of Neurology, Chicago, IL, April 1989.

Received March 21, 1989. Accepted for publication in final form September 28, 1989.




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