Impaired conduction of Ia sensory fibers in multifocal motor neuropathy: An electrophysiological demonstration
| Autor: | Eglė Sukockienė, André Truffert, Michel R. Magistris, Agustina M. Lascano, Ruxandra Iancu Ferfoglia |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
medicine.medical_treatment Mismatch negativity Neurophysiology Motor evoked potentials lcsh:RC321-571 03 medical and health sciences 0302 clinical medicine Physiology (medical) otorhinolaryngologic diseases medicine lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry H-reflex Achilles tendon business.industry 030208 emergency & critical care medicine medicine.disease musculoskeletal system Tendon Transcranial magnetic stimulation Quadriceps combined technique (QCT) T-response medicine.anatomical_structure Neurology MEP motor evoked potential Clinical and Research Article Anesthesia QCT quadriceps combined technique Reflex MMN multifocal motor neuropathy CB conduction block IV Ig intravenous immunoglobulins Neurology (clinical) business 030217 neurology & neurosurgery Multifocal motor neuropathy Sensory nerve |
| Zdroj: | Clinical Neurophysiology Practice, Vol 5, Iss, Pp 152-156 (2020) Clinical Neurophysiology Practice |
| Popis: | Highlights • Tendon areflexia may be observed in otherwise asymptomatic lower limbs, in patients with Multifocal Motor Neuropathy. • Sensory afferent pathways can be assessed electrophysiologically by recording T (tendon) and H (Hoffmann) waves. • Hypo-/areflexia may relate to Ia afferent impairment in Multifocal Motor Neuropathy. Objectives To report the clinical and electrophysiological findings in two patients with multifocal motor neuropathy (MMN) and bilateral absent patellar and Achilles tendon reflexes despite normal strength of quadriceps and calf muscles. Methods The medical history and clinical evaluation were completed by electrophysiological tests: sensory and motor nerve conduction studies, needle electromyography, motor-evoked potentials (MEPs) after transcranial magnetic stimulation, patellar T (tendon) responses, quadriceps and soleus H (Hoffman) reflex recordings. Results In the two patients, history, clinical evaluation, nerve conduction studies, favorable response to intravenous immunoglobulins, and positive anti-GM1 antibodies fulfilled the diagnosis of MMN. The lower limbs were asymptomatic, except for a unilateral weakness of foot dorsiflexion. The patellar and Achilles tendon reflexes disappeared during the course of the disease. The sensory nerve conduction studies were normal or minimally modified, M-wave and MEP/M amplitude ratio to the quadriceps were normal, patellar T (tendon) responses were virtually absent, and H-reflex to the quadriceps and soleus muscles were absent. Conclusions These observations, which show the interruption of the reflex afferent pathway, raise the question of Ia afferent involvement in the lower limbs of these two patients with MMN. Further investigations should determine the frequency and significance of these findings in this disorder. |
| Databáze: | OpenAIRE |
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