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Sensorimotor Perineuritis – An Autoimmune Disease?

Published online by Cambridge University Press:  18 September 2015

Christopher N. Bourque ,
Brian A. Anderson ,
C. Martin del Campo  and
Anders A. F. Sima
Christopher N. Bourque
Affiliation:
Department of Medicine, Section of Neurology, St. Boniface General Hospital and the Department of Pathology
Brian A. Anderson*
Affiliation:
Department of Medicine, Section of Neurology, St. Boniface General Hospital and the Department of Pathology
C. Martin del Campo
Affiliation:
Department of Medicine, Section of Neurology, St. Boniface General Hospital and the Department of Pathology
Anders A. F. Sima
Affiliation:
Department of Medicine, Section of Neurology, St. Boniface General Hospital and the Department of Pathology
*
Section of Neurology, St. Boniface General Hospital. 409 Tache Avenue, Winnipeg, Manitoba, Canada R2H 2A6
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Abstract:

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The literature contains a single description of sensory perineuritis (Asbury et al 1972). These patients demonstrated a painful, distal, sensory neuropathy, and examination of peripheral nerve biopsies revealed focal thickening and inflammatory infiltrates of the perineurium. We report a patient with sensorimotor peripheral nerve dysfunction, accompanied by progressive slowing of nerve conduction velocity. Examination of a sural nerve biopsy demonstrated focal thickening of the perineurium, inflammatory infiltrates, and necrosis of perineurial cells. Immunohistology revealed a patchy precipitation of IgG and IgM on perineurial cells. Ultrastructurally, mononuclear cells were found adjacent to perineurial cells undergoing necrosis. The patient showed gradual improvement partially coinciding with a course of steroid therapy. We suggest that this neuropathy is caused by damage to the perineurial barrier possibly by an immune-mediated destruction of perineurial cells and subsequent compression of the endoneurial content by perineurial scarring.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 12 , Issue 2 , May 1985 , pp. 129 - 133
Copyright
Copyright © Canadian Neurological Sciences Federation 1985

References

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