Multifocal nodular hypertrophy of trigeminal nerve in multifocal acquired demyelinating sensory and motor neuropathy

摘要

A 60-year-old woman presented with asymmetric distal limb weakness and muscle atrophy.Electrophysiologic study revealed demyelinating polyneuropathy, and she was diagnosed withmultifocal acquired demyelinating sensory and motor (MADSAM) neuropathy as a subtype ofchronic inflammatory demyelinating polyneuropathy (CIDP) based on the established diagnostic criteria.1 Anti-neurofascin155 antibody was negative. Cervical and lumbosacral nerveroots showed asymmetric multifocal hypertrophy (figure 1), which were distinct from those intypical CIDP.2 Brain MRI revealed multifocal nodular hypertrophy of trigeminal nerves (figure2 and video 1). These hypertrophic patterns in trigeminal nerves as well as nerve roots might becharacteristics of MADSAM neuropathy.