RESUMEN
- Multifocal motor neuropathy (MMN) is a chronic demyelinating neuropathy mainly characterized by multifocal distribution; affecting only motor nerve fibers of two or more peripheral nerves, with the absence of symptoms and signs of upper motor neuron; chronic, sometimes cascading progressive course; demyelination with partial block of motor conduction; immune-mediated pathogenesis and good response to intravenous immunoglobulin treatment (IVIG). The diagnosis of MMN is based on clinical, laboratory and electrophysiological characteristics. Steroids are ineffective in MMN and may lead to worsening of the disease. Similarly, therapeutic plasma exchange is negligibly effective in this neuropathy. However, more than 80% of patients with MMN experience improvement after IVIG. We present our three cases of MMN with positive response to IVIG.
Asunto(s)
Enfermedades Desmielinizantes , Inmunoglobulinas Intravenosas/administración & dosificación , Enfermedad de la Neurona Motora , Adolescente , Adulto , Enfermedades Desmielinizantes/diagnóstico , Enfermedades Desmielinizantes/fisiopatología , Enfermedades Desmielinizantes/terapia , Electromiografía/métodos , Femenino , Humanos , Factores Inmunológicos/administración & dosificación , Masculino , Enfermedad de la Neurona Motora/diagnóstico , Enfermedad de la Neurona Motora/fisiopatología , Enfermedad de la Neurona Motora/terapia , Conducción Nerviosa , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
The accessory deep peroneal (ADPN) nerve has been regarded as an anomalous nerve derived from the superficial peroneal nerve or its branch and supplies motor innervations for extensor digitorum brevis (EDB) and sensory innervations for the lateral part of the ankle and foot regions. The EDB is usually innervated exclusively by the deep peroneal nerve, a major branch of the the common peroneal nerve, however, in as many as 28% of patients (with same male/female frequency), one or both of the EDB muscles are (partially or exclusively) innervated by the ADPN nerve. This anomaly appears to be inherited in autosomal dominant fashion with incomplete gene penetrance. ADPN existence is of great clinical and surgical importance, and the aim of this study is to describe a very rare case of coexistence ADPN and anterior tarsal tunnel syndrome.