Sensory neuropathy as the initial manifestation of multiple system atrophy
Wu, Y-Ru.; Chen, C-Mei.; Ro, L-Sun.; Lyu, R-Kuo.; Tang, L-Ming.
Journal of the Formosan Medical Association 103(9): 727-730
2004
ISSN/ISBN: 0929-6646 PMID: 15361949 Document Number: 568465
Peripheral neuropathy is usually subtle or subclinical in patients with multiple system atrophy (MSA). A 54-year-old man who initially presented with sensory polyneuropathy developed extrapyramidal and cerebellar signs and autonomic failure typical of MSA 7 years later. Sural nerve biopsy disclosed a prominent loss of large myelinated fibers, whereas the unmyelinated fibers were totally spared. These findings imply that sensory neuropathy can be part of the multiple-site degeneration in MSA, and that predominant involvement of large myelinated fibers of the sensory nerves can be a presenting feature.