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Journal of the Korean Geriatrics Society 1999;3(4):56-61.
Published online December 31, 1999.
Non-systemic Vasculitic Neuropathy Presenting as Ascending Paralysis
Hyeon Seok Yu, Sung Min Kim, Ki Han Kwon, Byung Chul Lee, Jun Hyeon Shin, In Soo Kang
상행성 운동마비와 보행 실조로 발현한 비전신성 혈관염성 신경병증 1예
Abstract
Typical vasculitic neuropathy commonly manifests as a subacute multiple mononeuropathy, symmetrical or asymmetrical sensori-motor polyneuropathy. Various clinical presentations of peripheral neuropathy may confuse the diagnostic approach sometimes. A 76-year old man presented progressive areflexic ascending paralysis. gait ataxia, severe vibration and position sense impairment for 1 month. We initially considered as subacute demyelinating polyneuropathy. Electrophysiologic studies showed mainly axonopathy with some evidence of demyelination. We performed sural nerve biopsy and diagnosed as vasculitic neuropathy. No laboratory data or clinical findings favored systemic vasculitic involvement. So we concluded vasculitis confined to the peripheral nerves. Vasculitic neuropathy rarely presented as large myelinated nerve fiber disease. It should be considered the clinical variability of vasculitic neuropathy so extensive studies are needed in the case of peripheral polyneuropathy with indefinite cause.
Key Words: Vasculitic neuropathy, Gait ataxia, Ascending paralysis
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