Impaired conduction of Ia sensory fibers in multifocal motor neuropathy : An electrophysiological demonstration

Article Article scientifique Rapport de cas Impaired conduction of Ia sensory fibers in multifocal motor neuropathy : An electrophysiological demonstration eng 2020-08-07 2020 author Sukockiene Egle Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland.,Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. 981554 author Magistris Michel Faculty of Medicine, Geneva University, Geneva, Switzerland. 57077 author Iancu Ferfoglia Ruxandra Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland. 586638 author Lascano Agustina Maria 0000-0001-7572-8811 Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland. 636053 Département des neurosciences cliniques (OTONO) author Truffert André Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland. 108064 152-156 10.1016/j.cnp.2020.07.002 32913936 2467-981X PMC7473831 https://www.sciencedirect.com/science/article/pii/S2467981X20300226 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. CB, conduction block H-reflex IV Ig, intravenous immunoglobulins MEP, motor evoked potential MMN, multifocal motor neuropathy Motor evoked potentials Neurophysiology QCT, quadriceps combined technique Quadriceps combined technique (QCT) T-response Transcranial magnetic stimulation Dewey 616.8 61 Département des neurosciences cliniques 226 false Clinical neurophysiology practice 5 8a667c53-65db-4b2b-b2f8-2c50116c7672 Article (Published version) Public clin_neurophy_practice.pdf 281858 application/pdf CC BY-NC-ND-4.0 0a47dd04ecf13b6e53677643aef517bbd992b7808e702520f23af969b7cfc11b 49a5808c-532e-4ae1-b6f7-b2f89360a31f Supplemental data Public 1-s2.0-S2467981X20300226-mmc1(2).docx 27299 application/vnd.openxmlformats-officedocument.wordprocessingml.document 719b41d6f2e194b1bdc2fe9a235ae6a6cd00bb203d78bfdcca8de8b8839d36cd 9ed95fe9-30ae-491a-bbec-441ca485ec6e Supplemental data Public 1-s2.0-S2467981X20300226-mmc2(2).docx 15988 application/vnd.openxmlformats-officedocument.wordprocessingml.document c834dd20a0e74846cf9b42fb91f4cb855befbd2baed90c53c5dc0958b8c3108e openAccess Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques

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Impaired conduction of Ia sensory fibers in multifocal motor neuropathy : An electrophysiological demonstration	Clinical neurophysiology practice			2020	53	114

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Sukockiene, Egle