RESUMO
Parkinson's disease (PD) is a progressive neurodegenerative disorder. In our research for patients with PD, they were having trouble with posture disorder, gait disorder, fatigue and constipation. And almost of them have gotten some exercise to keep their health and felt beneficial effect of exercise. Rehabilitation for patients with PD is one of standard therapies of PD and includes stretching, muscle training, exercise using external cueing strategies and walking. Recently, the exercise effect includes the report of the effect on PD progression. It is important that we confirm the needs of patients with PD and start rehabilitation at an early stage to prevent movement disorder.
Assuntos
Doença de Parkinson/reabilitação , Terapia por Exercício , HumanosAssuntos
Dissecção Aórtica/cirurgia , Dissecção Aórtica/terapia , Doença de Moyamoya/cirurgia , Guias de Prática Clínica como Assunto/normas , Dissecção Aórtica/fisiopatologia , Angiopatia Amiloide Cerebral/fisiopatologia , Angiopatia Amiloide Cerebral/terapia , Demência Vascular/fisiopatologia , Demência Vascular/terapia , Humanos , Embolia Intracraniana/fisiopatologia , Embolia Intracraniana/terapia , Trombose Intracraniana/fisiopatologia , Trombose Intracraniana/terapia , Doença de Moyamoya/fisiopatologiaAssuntos
Transtornos Cognitivos/reabilitação , Transtornos dos Movimentos/reabilitação , Guias de Prática Clínica como Assunto/normas , Distúrbios da Fala/reabilitação , Reabilitação do Acidente Vascular Cerebral , Bexiga Urinaria Neurogênica/reabilitação , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/fisiopatologia , Humanos , Transtornos dos Movimentos/etiologia , Transtornos dos Movimentos/fisiopatologia , Distúrbios da Fala/etiologia , Distúrbios da Fala/fisiopatologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/fisiopatologia , Bexiga Urinaria Neurogênica/etiologia , Bexiga Urinaria Neurogênica/fisiopatologiaAssuntos
Procedimentos Neurocirúrgicos/normas , Guias de Prática Clínica como Assunto/normas , Hemorragia Subaracnóidea/terapia , Procedimentos Cirúrgicos Vasculares/normas , Artérias Cerebrais/patologia , Artérias Cerebrais/fisiopatologia , Artérias Cerebrais/cirurgia , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/normas , Humanos , Procedimentos Neurocirúrgicos/métodos , Assistência Perioperatória/métodos , Assistência Perioperatória/normas , Hemorragia Subaracnóidea/fisiopatologia , Procedimentos Cirúrgicos Vasculares/métodosAssuntos
Doenças Assintomáticas/terapia , Doenças das Artérias Carótidas/diagnóstico , Hemorragia Cerebral/diagnóstico , Guias de Prática Clínica como Assunto/normas , Infarto Encefálico/diagnóstico , Infarto Encefálico/fisiopatologia , Infarto Encefálico/terapia , Doenças das Artérias Carótidas/etiologia , Doenças das Artérias Carótidas/fisiopatologia , Hemorragia Cerebral/fisiopatologia , Hemorragia Cerebral/terapia , Humanos , Aneurisma Intracraniano/diagnóstico , Aneurisma Intracraniano/etiologia , Aneurisma Intracraniano/fisiopatologiaAssuntos
Infarto Cerebral/terapia , Ataque Isquêmico Transitório/terapia , Guias de Prática Clínica como Assunto/normas , Anticoagulantes/uso terapêutico , Infarto Cerebral/complicações , Infarto Cerebral/fisiopatologia , Fibrinolíticos/uso terapêutico , Humanos , Hipotermia Induzida/normas , Ataque Isquêmico Transitório/complicações , Ataque Isquêmico Transitório/fisiopatologia , Fármacos Neuroprotetores/uso terapêutico , Inibidores da Agregação Plaquetária/uso terapêuticoAssuntos
Acidente Vascular Cerebral/terapia , Edema Encefálico/etiologia , Edema Encefálico/fisiopatologia , Edema Encefálico/terapia , Humanos , Hipertensão/etiologia , Hipertensão/fisiopatologia , Hipertensão/terapia , Japão/epidemiologia , Guias de Prática Clínica como Assunto/normas , Síndrome do Desconforto Respiratório/etiologia , Síndrome do Desconforto Respiratório/fisiopatologia , Síndrome do Desconforto Respiratório/terapia , Comportamento de Redução do Risco , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/prevenção & controleAssuntos
Hipertensão/complicações , Hipertensão/fisiopatologia , Hemorragia Intracraniana Hipertensiva/fisiopatologia , Hemorragia Intracraniana Hipertensiva/terapia , Guias de Prática Clínica como Assunto/normas , Edema Encefálico/fisiopatologia , Edema Encefálico/prevenção & controle , Edema Encefálico/terapia , Gastroenteropatias/fisiopatologia , Gastroenteropatias/prevenção & controle , Gastroenteropatias/terapia , Técnicas Hemostáticas/normas , Humanos , Hipertensão/tratamento farmacológico , Convulsões/fisiopatologia , Convulsões/prevenção & controle , Convulsões/terapiaRESUMO
OBJECTIVE: Recent reports demonstrated that low-frequency repetitive transcranial magnetic stimulation (rTMS) over the unaffected hemisphere improved the affected hand function in chronic stroke patients. We investigated whether 1 Hz rTMS improved the motor learning of the affected hand in patients after stroke. DESIGN: A double-blind study. PATIENTS: Twenty patients with chronic subcortical stroke. METHODS: The patients were randomly assigned to receive either a sub-threshold rTMS over the unaffected hemisphere (1 Hz, 25 minutes) or sham stimulation, and all patients performed a pinching task after stimulation. We evaluated the motor function of the affected hand and the excitatory and inhibitory function of the affected motor cortex by transcranial magnetic stimulation. RESULTS: Compared with sham stimulation, rTMS induced an increase in the excitability of the affected motor cortex(p < 0.001) and an improvement in acceleration of the affected hand (p = 0.006). Moreover, the effect of motor training on pinch force was enhanced by rTMS (p < 0.001). These improvement in the motor function lasted for one week after rTMS and motor training (p < 0.001). CONCLUSION: rTMS improved the motor learning of the affected hand in patients after stroke; thus, it can apply as anew rehabilitation strategy for patients after stroke.
Assuntos
Mãos/fisiopatologia , Atividade Motora/fisiologia , Córtex Motor/fisiologia , Paresia/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Estimulação Magnética Transcraniana , Adulto , Idoso , Método Duplo-Cego , Potencial Evocado Motor/fisiologia , Força da Mão/fisiologia , Humanos , Pessoa de Meia-Idade , Plasticidade Neuronal/fisiologia , Paresia/reabilitação , Recuperação de Função Fisiológica , Reabilitação do Acidente Vascular CerebralRESUMO
We present a case report of a 56-yr-old chronic stroke patient with right hemiparesis who was treated with repetitive transcranial magnetic stimulation (rTMS) therapy. Before stroke, the patient had suffered an accident that led to paralysis and contracture of the left upper limb, and, subsequently, he was forced to use only his right upper limb for routine activities, despite right hemiparesis. We performed subthreshold rTMS (1 Hz, 25 mins) and sham stimulation of the contralesional primary motor cortex (M1) at different times. Immediately after rTMS, the patient was able to write characters with increased speed and accuracy, and this effect continued for more than 7 days; however, this was not the case after sham stimulation. Moreover, the writing practice after rTMS improved the patient's pinch force.
Assuntos
Paresia/reabilitação , Recuperação de Função Fisiológica , Reabilitação do Acidente Vascular Cerebral , Estimulação Magnética Transcraniana , Lateralidade Funcional , Humanos , Masculino , Pessoa de Meia-Idade , Destreza Motora , Paresia/etiologia , Modalidades de Fisioterapia , Acidente Vascular Cerebral/complicaçõesRESUMO
BACKGROUND AND PURPOSE: The mechanism of reorganization after stroke remains uncertain. Several studies that have measured reaction time (RT) delay by transcranial magnetic stimulation (TMS) have revealed some substrates responsible for the reorganization of motor recovery. In this study, we evaluated the RT delay and inhibitory functions by examining the silent period (SP) in the primary motor cortex (M1) and premotor cortex (PMC) of the affected hemisphere. Using these data, we investigated whether a change in the inhibitory system might influence motor recovery. METHODS: This study was performed in 20 patients with chronic subcortical stroke. To evaluate the RT delay, TMS was applied to the affected hemisphere 100 ms after showing the cue that indicated paretic finger movement. The SP was induced by TMS over the affected hemisphere during voluntary contraction of the paretic hand. RESULTS: The RT delays of the PMC were more prominent in patients with greater disability. The ratio of SP duration to RT delay in the PMC decreased with the decline in motor function. Moreover, upper arm function was better than hand function in patients with a decreased SP in the PMC. CONCLUSIONS: The inhibitory function of the PMC was disturbed in patients with poor motor function. Stroke patients with poor motor ability appeared to depend not only on the motor pathway from M1 but also on other parallel motor circuits to move the paretic side. However, this brain reorganization might result in the sacrifice of function of the affected hand.
Assuntos
Córtex Motor/fisiopatologia , Paresia/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Adulto , Idoso , Feminino , Dedos , Mãos , Humanos , Masculino , Pessoa de Meia-Idade , Paresia/etiologia , Desempenho Psicomotor , Tempo de Reação/fisiologia , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Estimulação Magnética TranscranianaRESUMO
PRIMARY OBJECTIVE: To study whether transcallosal inhibition (TCI) can evaluate the severity of traumatic brain injury (TBI). RESEARCH DESIGN: Case-control study. METHODS AND PROCEDURES: Twenty patients with a chronic TBI and 20 control subjects were studied. The following transcranial magnetic stimulation parameters were checked; resting motor threshold, central motor latency times, onset latency of TCI, duration of TCI, transcallosal conduction times and amount of TCI. The severity of TBI was evaluated using the Glasgow Coma Scale (GCS). MAIN OUTCOME AND RESULTS: The amount of TCI was significantly lower in the patients than the control subjects (p < 0.001). The amount of TCI was highly correlated with the GCS (r = 0.787, p < 0.001). CONCLUSION: An assessment of TCI was found to be a more sensitive and useful method for an evaluation of the severity of TBI.
Assuntos
Lesões Encefálicas/fisiopatologia , Corpo Caloso/fisiologia , Estimulação Magnética Transcraniana , Adulto , Estudos de Casos e Controles , Doença Crônica , Eletromiografia , Potencial Evocado Motor/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tempo de Reação/fisiologiaRESUMO
To evaluate the correlations between memory function and intelligence and event-related potential, the P300 component for different tasks was studied for 30 post-traumatic brain injury patients (mean age 31.6 +/- 13.7 years; 23 male and 7 female). Memory function, intelligence, and depression were measured by using the Mini-Mental State Examination, the revised Wechsler Adult Intelligence Scale and the Self-Rating Depression Scale, respectively. P300 latency was measured during silent-count and button-press tests at three midline scalp (Fz, Cz, and Pz) sites for all subjects by using an auditory 'odd-ball' paradigm. Neuropsychological memory score was predicted by intelligence score, but neurophysiological P300 latency was predicted by memory score for the silent-count test and by intelligence score for the button-press test. These results show that the P300 event-related potential component is sensitive to the diverse nature of cognitive deficits in post-traumatic brain injury patients during different types of discrimination tasks. However, future research is necessary to replicate and extend these findings.
Assuntos
Lesões Encefálicas/fisiopatologia , Lesões Encefálicas/psicologia , Córtex Cerebral/fisiopatologia , Potenciais Evocados/fisiologia , Transtornos da Memória/fisiopatologia , Transtornos da Memória/psicologia , Transtornos de Adaptação/diagnóstico , Transtornos de Adaptação/etiologia , Transtornos de Adaptação/fisiopatologia , Adulto , Lesões Encefálicas/diagnóstico , Córtex Cerebral/lesões , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/fisiopatologia , Transtornos Cognitivos/psicologia , Humanos , Inteligência/fisiologia , Testes de Inteligência , Transtornos da Memória/etiologia , Testes Neuropsicológicos , Valor Preditivo dos Testes , Desempenho Psicomotor/fisiologia , Tempo de Reação/fisiologiaRESUMO
BACKGROUND AND PURPOSE: A recent report has demonstrated that the contralesional primary motor cortex (M1) inhibited the ipsilesional M1 via an abnormal transcallosal inhibition (TCI) in stroke patients. We studied whether a decreased excitability of the contralesional M1 induced by 1 Hz repetitive transcranial magnetic stimulation (rTMS) caused an improved motor performance of the affected hand in stroke patients by releasing the TCI. METHODS: We conducted a double-blind study of real versus sham rTMS in stroke patients. After patients had well- performed motor training to minimize the possibility of motor training during the motor measurement, they were randomly assigned to receive a subthreshold rTMS at the contralesional M1 (1 Hz, 25 minutes) or sham stimulation. RESULTS: When compared with sham stimulation, rTMS reduced the amplitude of motor-evoked potentials in contralesional M1 and the TCI duration, and rTMS immediately induced an improvement in pinch acceleration of the affected hand, although a plateau in motor performance had been reached by the previous motor training. This improvement in motor function after rTMS was significantly correlated with a reduced TCI duration. CONCLUSIONS: We have demonstrated that a disruption of the TCI by the contralesional M1 virtual lesion caused a paradoxical functional facilitation of the affected hand in stroke patients; this suggests a new neurorehabilitative strategy for stroke patients.
Assuntos
Mãos/fisiopatologia , Córtex Motor/fisiopatologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/fisiopatologia , Estimulação Magnética Transcraniana/métodos , Adulto , Idoso , Análise de Variância , Corpo Caloso/fisiopatologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Destreza Motora , Recuperação de Função Fisiológica , Análise e Desempenho de TarefasRESUMO
Human T-lymphotropic virus type I (HTLV-I) is known to be the causative agent of the chronic myelopathy, HTLV-I--associated myelopathy (HAM), and on rare occasions infection is also associated with the development of polyneuropathy. Here the authors present an HTLV-I--positive family of whom four members developed a chronic demyelinating polyneuropathy without HAM. Four female patients in a family from Hokkaido in Japan developed distal dominant paresthesia and muscle weakness in the second and third decades of their life. Neurological findings at ages ranging from 50 to 65 years included mild painful sensorimotor disturbances with atrophy of the distal parts of the extremities but without pyramidal signs or hyperactive tendon reflexes. Magnetic resonance imaging (MRI) findings of brain and spinal cord were unremarkable. Serum HTLV-I antibody levels were elevated at 1:8192 to 1:32,768, whereas those in cerebrospinal fluid were low at 1:4 to 1:8. Electrophysiological studies revealed polyphasic compound muscle action potentials with denervation potentials on nerve conduction studies and neurogenic patterns by electromyography, which were consistent with signs of chronic motor dominant demyelinating polyneuropathy. Sural nerve biopsy showed decreased myelinated fibers, occurrence of globule formation, myelin ovoid and remyelinated fibers, and an infiltration of CD68-positive macrophages with occasional CD4-positive T cells in the nerve fascicles. The polyneuropathy was responsive to steroid therapy. Analyses of serological human leukocyte antigen (HLA) types indicated that none of the patients possessed a high-risk HLA type known to be associated with adult T-cell leukemia (ATL), whereas they did have high responsive alleles to HTLV-I env similar to that observed in HAM. Nucleotide sequence analysis of the HTLV-I tax region demonstrated the B subgroup in all patients. This study suggests that HTLV-I infection can result in the development of a familial form of polyneuropathy that is associated with distinct HLA class I alleles, which might possibly involve a distinct virus subtype.
Assuntos
Infecções por HTLV-I/complicações , Vírus Linfotrópico T Tipo 1 Humano , Polineuropatias/etiologia , Polineuropatias/patologia , Anticorpos Antivirais/sangue , Anticorpos Antivirais/líquido cefalorraquidiano , Células Sanguíneas/virologia , Feminino , Produtos do Gene tax/genética , Infecções por HTLV-I/sangue , Infecções por HTLV-I/líquido cefalorraquidiano , Infecções por HTLV-I/diagnóstico , Vírus Linfotrópico T Tipo 1 Humano/genética , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Humanos , Antígenos Comuns de Leucócito/biossíntese , Macrófagos/imunologia , Pessoa de Meia-Idade , Debilidade Muscular/patologia , Fibras Nervosas Mielinizadas/patologia , Parestesia/patologia , Linhagem , Polineuropatias/genética , Análise de Sequência de DNA , Nervo Sural/imunologia , Nervo Sural/patologiaRESUMO
Transcranial magnetic stimulation (TMS) elicits short latency excitatory responses in the target muscles, termed motor evoked potential (MEP). When TMS is delivered during a voluntary contraction, the MEP is followed by a period of silence called silent period (SP). These MEP parameters are in general recordable by electromyography (EMG). Mechanomyography (MMG) on the other hand is the mechanical counterpart of EMG. Thus, this study has been conducted to observe whether the MEP parameters from MMG signals showed similar trait of EMG recordings. Five normal healthy male subjects were included in this study. The subjects were required to perform right biceps brachii muscles contraction at diverse graded of load level at 5, 10, 20, 30, 40, 60, and 100% maximum voluntary contraction (MVC). MEPs by single pulse TMS on left hemisphere were obtained from both EMG electrode and MMG accelerometer at rest and at different levels of predetermined load level. MEP amplitude and area obtained both from EMG and MMG record were increased with the increase of muscle contraction with a maximum of 60% MVC. With increasing the level of contraction there was a shortening of onset latency and decreasing in the length of silent period in both EMG and MMG signals. We also recorded the EMG- and MMG-MEP from the right extensor carpi radialis muscle during transcutaneous electric nerve stimulation in order to observe neural changes in sensory stimulation from both EMG and MMG responses. The EMG-MEP was not visible in electrical artifact whereas it was obvious in MMG responses. In accordance with other study, this study showed that the voluntary contraction of biceps brachii muscle influenced the MEP parameter which are moreover obtainable by MMG even in electrical noise may provide insight for future study.
Assuntos
Potencial Evocado Motor/fisiologia , Músculo Esquelético/inervação , Músculo Esquelético/fisiologia , Miografia , Estimulação Magnética Transcraniana , Estimulação Elétrica Nervosa Transcutânea , Adulto , Braço/inervação , Braço/fisiologia , Eletromiografia , Humanos , Masculino , Contração Muscular/fisiologiaRESUMO
OBJECTIVE: To report on the effectiveness and side effects of 2% phenol block in patients with cervical dystonia (CD). DESIGN: Case series. SETTING: A rehabilitation department at a university medical center in Japan. PARTICIPANTS: Sixteen patients (11 men, 5 women; mean age +/- standard deviation, 43.4+/-11.2y) with CD. The cause of the CD was unknown, and all cases were refractory to the oral medication and rehabilitation therapy. INTERVENTION: Two percent phenol blocks guided by electromyography. MAIN OUTCOME MEASURES: A blind analysis by neurologists of the Tsui score before and after 2 weeks of treatment with phenol block. Side effects were evaluated by another neurologist and patient report. RESULTS: There was significant (P=.0002) improvement in neck movement and position, based on a reduced Tsui score, after the phenol block. However, 4 patients had a complication of sensory disturbance of the transverse cutaneous nerve of the neck area. The sensory disturbances decreased gradually and disappeared within 3 months, whereas the effects of the phenol block continued. CONCLUSIONS: Phenol block can reduce the impact of CD that is refractory to therapy.
Assuntos
Bloqueio Nervoso , Fármacos Neuromusculares/administração & dosagem , Bloqueio Neuromuscular/métodos , Fenol/administração & dosagem , Torcicolo/reabilitação , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculos do Pescoço/efeitos dos fármacosRESUMO
Dysferlinopathy and rigid spine syndrome occurring in a 50-year-old man is reported. The patient noticed stiffness of knee and ankle joints, which gradually extended to neck, wrist and elbow joints leading to difficulty in anterior flexion. Muscular weakness and wasting of the lower extremities had developed since age 40, accompanied by a limitation of anterior bending of the spine. Elevated serum CK was noticed. Muscle CT revealed atrophy with moderate fatty replacement of muscles in the neck, shoulder and pelvic girdle, and marked replacement in the para-vertebral muscles, posterior compartment of hamstrings and calf muscles. Electromyography showed a typical myogenic pattern, and muscle biopsy disclosed dystrophic changes, compatible with limb-girdle muscular dystrophy 2B. Loss of dysferlin expression was verified by immunohistochemistry, which was confirmed by a mini-multiplex Western blotting system. Gene analyses of the dysferlin gene disclosed compound heterozygotes for frameshift (G3016 + 1A) and a missense mutation (G3370T). This study might propose some clues to resolve the combination of musular dystrophies and rigid spine syndrome.
Assuntos
Proteínas de Membrana/deficiência , Proteínas Musculares/deficiência , Rigidez Muscular/patologia , Distrofias Musculares/patologia , Doenças da Coluna Vertebral/patologia , Disferlina , Humanos , Masculino , Proteínas de Membrana/genética , Pessoa de Meia-Idade , Proteínas Musculares/genética , Rigidez Muscular/genética , Rigidez Muscular/metabolismo , Distrofias Musculares/genética , Distrofias Musculares/metabolismo , Doenças da Coluna Vertebral/genética , Doenças da Coluna Vertebral/metabolismo , SíndromeRESUMO
Paraneoplastic syndrome (PNS) with two distinct neurological features was reported in a 50-year-old man who presented initially with vertigo, ataxia, dysarthria, tremor, confusion, urinary retention and hypotension. Pulmonary X-ray findings, class IIIb sputum cytology, and positive anti-Hu antibody established the diagnosis of PNS associated with small-cell lung cancer (SCLC). Two cycles of combined chemotherapy resulted in shrinkage of the lung tumor together with complete recovery of neurological symptoms and disappearance of anti-Hu antibody. Relapse of SCLC 4 months later with re-appearance of anti-Hu antibody required additional chemotherapy and irradiation. Eight months later, when multiple liver metastasis of SCLC was noticed, muscular weakness with positive waxing phenomenon compatible with Lambert-Eaton myasthenic syndrome (LEMS) developed. Postmortem examinations revealed residual SCLC in the primary lung, and massive liver metastasis with generalized lymph node involvement, but no tumors in the CNS. In the cerebellum, there was a slight loss of Purkinje cells with torpedo formation but without apparent lymphocytic infiltration. The present PNS was unique in that the relapse of SCLC was accompanied by the appearance of anti-Hu antibody, and that initial signs of brainstem-cerebellar symptoms, encephalopathy and autonomic failure were replaced by LEMS coinciding with the tumor recurrence.
Assuntos
Carcinoma de Células Pequenas/complicações , Síndrome Miastênica de Lambert-Eaton/etiologia , Neoplasias Pulmonares/complicações , Recidiva Local de Neoplasia/imunologia , Proteínas de Ligação a RNA/imunologia , Autoanticorpos/sangue , Autoanticorpos/líquido cefalorraquidiano , Western Blotting , Tronco Encefálico/patologia , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Pequenas/terapia , Cerebelo/patologia , Proteínas ELAV , Humanos , Imuno-Histoquímica , Síndrome Miastênica de Lambert-Eaton/fisiopatologia , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Degeneração Paraneoplásica Cerebelar/patologiaRESUMO
In recent years a novel problem has arisen in organ transplantation medicine, namely GVHD. The nervous system has been involved mainly at the level of the CNS and this can lead to a serious outcome for the patient. In rare cases, peripheral nerves may be affected and show acute or chronic polyneuropathy. Here a case is reported of polyneuropathy associated with chronic GVHD. A 32-year-old man, suffering from chronic GVHD following an allogeneic bone marrow transplantation (BMT) for malignant lymphoma at the age of 25, developed a motor dominant polyneuropathy 5 years later. Electrophysiologic studies demonstrated the demyelinating type of polyneuropathy. Biopsy specimens from skin and skeletal muscle disclosed perivascular lymphocytic infiltrates expressing T-cell markers. The sural nerve showed a loss of myelinated nerve fibers with epineurial fibrosis and rare occurrence of T cells, but without obvious vasculitic changes. The present case suggested that polyneuropathy could develop in association with chronic GVHD in some patients with a long-standing disease course.