A case of acute autonomic, sensory and motor neuropathy with swelling and gadolinium enhancement of bilateral trigeminal nerve on MRI and dissociation between superficial and deep sensation disturbance

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  • Naito Hiroyuki
    Department of Neurology, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital
  • Doi Hikaru
    Department of Neurology, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital
  • Inamizu Saeko
    Department of Neurology, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital
  • Ito Hijiri
    Hananosato, Miyoshi Neurology Clinic
  • Araki Takehisa
    Department of Neurology, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital

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Other Title
  • 脳神経障害を合併しMRI にて三叉神経の腫大・造影効果を呈した急性自律性感覚性運動性ニューロパチーの1例
  • 症例報告 脳神経障害を合併しMRIにて三叉神経の腫大・造影効果を呈した急性自律性感覚性運動性ニューロパチーの1例
  • ショウレイ ホウコク ノウ シンケイ ショウガイ オ ガッペイ シ MRI ニテ サンサ シンケイ ノ シュダイ ・ ゾウエイ コウカ オ テイシタ キュウセイ ジリツ セイカンカクセイ ウンドウセイ ニューロパチー ノ 1レイ

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Abstract

We report a case of a 46-year old man with acute autonomic, sensory and motor neuropathy (AASMN). He developed severe orthostatic hypotension, anuria,anhydrosis, tonic pupil with dysarthria, dysphagia, jaw claudication, and dysesthesia and sharp pain several days after symptom of upper respiratory infection. Neurological examination revealed severely decreased superficial sensation with normal deep sensation. Brain MRI findings showed bilateral trigeminal nerve swelling with gadolinium (Gd) enhancement. His motor and sensory symptoms and MRI abnormality were improved after the administration of intravenous immunoglobulin and intravenous methylprednisolone therapy; however his autonomic symptoms scarcely reacted to these immunotherapies. As long as we investigated in AASMN cases, bilateral trigeminal nerve swelling with Gd enhancement and dissociation between superficial and deep sensation disturbance have not reported, suggesting that the present case mainly disrupted C nerve fibers distributing postganglionic autonomic and temperature-pain sensory nerves.

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 53 (2), 125-130, 2013

    Societas Neurologica Japonica

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