1. Subacute peripheral and optic neuropathy syndrome with no evidence of a toxic or nutritional cause.
- Author
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Allen D, Riordan-Eva P, Paterson RW, and Hadden RD
- Subjects
- Adult, Alcoholism epidemiology, Anti-Inflammatory Agents therapeutic use, Cerebrospinal Fluid Proteins analysis, Electromyography, Electroretinography, Evoked Potentials, Visual physiology, Female, Humans, London epidemiology, Male, Middle Aged, Neural Conduction, Neurologic Examination, Nutritional Status, Optic Nerve Diseases drug therapy, Pain etiology, Peripheral Nervous System Diseases drug therapy, Polyneuropathies complications, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating complications, Retrospective Studies, Steroids therapeutic use, Syndrome, Visual Acuity, Optic Nerve Diseases complications, Optic Nerve Diseases etiology, Peripheral Nervous System Diseases complications, Peripheral Nervous System Diseases etiology
- Abstract
Background: The syndrome of subacute simultaneous peripheral neuropathy and bilateral optic neuropathy is known to occur in tropical countries, probably due to malnutrition or toxicity, but not often seen in developed countries. We report seven patients in London who were not malnourished or alcoholic, and in whom no clear cause was found., Methods: We retrospectively reviewed the case notes and arranged some further investigations., Results: All patients developed peripheral and bilateral optic neuropathy within 6 months. Patients were aged 30-52, and all of Jamaican birth and race but lived in the UK. Most had subacute, painful ataxic sensory axonal neuropathy or neuronopathy, some with myelopathy. Nerve conduction studies revealed minor demyelinating features in two cases. The optic neuropathy was symmetrical, subacute and monophasic, usually with marked reduction in visual acuity. CSF protein concentration was usually elevated but other laboratory investigations were normal. Patients showed only modest improvement at follow-up., Conclusion: These patients share a common clinical and electrophysiological phenotype, age, ethnicity and elevated CSF protein, but otherwise normal laboratory investigations. The syndrome is a cause of significant morbidity in young people. The cause remains uncertain despite thorough investigation., (Copyright © 2013 Elsevier B.V. All rights reserved.)
- Published
- 2013
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