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Brain, Vol. 113, No. 6, 1629-1643, 1990
© 1990 Guarantors of Brain


research-article

CONGENITAL DEMYELINATING MOTOR AND SENSORY NEUROPATHY WITH FOCALLY FOLDED MYELIN SHEATHS

A. A. W. M. GABREËLS-FESTEN1,, E. M. G. JOOSTEN1, F. J. M. GABREËLS1, D. F. STEGEMAN1, A. J. M. VOS2 and H. F. M. BUSCH3

1Institute of Neurology, University Hospital Nijmegen 2Department of Neurology, Gelderse Vallei Hospital Ede 3Department of Neurology, University Hospital Rotterdam, The Netherlands

Correspondence to: Correspondence to: Dr A. A. W. M. Gabreels-Festen, Institute of Neurology, University Hospital Nijmegen. Po Box 9101, 6500 HB Nijmegen, The Netherlands.

Six patients (5 index cases and 1 sib) with a congenital motor and sensory neuropathy are described. The clinical, genetic and electrophysiological features resembled Dejerine-Sottas disease or hereditary motor and sensory neuropathy (HMSN) type III. Sural nerve biopsy of 5 patients revealed segmental demyelination and remyelination with hypertrophic changes, although onion bulbs were not as ubiquitous as in classical HMSN type III. A striking discriminating feature from HMSN type III was an abundance of focal myelin thickenings (tomacula) present in nearly all teased fibres. Possible pathogenic implications are discussed. These cases corroborate the heterogeneity of congenital motor and sensory neuropathies.

Received June 28, 1989. Revised October 17, 1989. Accepted November 6, 1989.


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