Yonsei Med J.  2012 Mar;53(2):446-449. 10.3349/ymj.2012.53.2.446.

A Case of Acute Polyneuropathy with Nephrotic Syndrome Showing Transient Proximal Sensory Conduction Defects

Affiliations
  • 1Department of Neurology, Konkuk University School of Medicine, Seoul, Korea.
  • 2Department of Neurology, Yonsei University College of Medicine, Seoul, Korea. sunwooin@yuhs.ac

Abstract

Acute sensorimotor polyneuropathy that resembles Guillain-Barre syndrome (GBS) is rarely accompanied with nephrotic syndrome, and its underlying immunological mechanisms are unclear. A 56-year-old man presented with simultaneous acute progressive symmetric sensorimotor polyneuropathy and proteinuria. A kidney biopsy revealed focal segmental glomerulosclerosis. Serial electrophysiologic studies showed only a transient proximal conduction block in the median nerve, stimulated somatosensory evoked potential and prolonged terminal latencies of the median and peroneal nerves. The patient's neurologic deficits and kidney dysfunction recovered with corticosteroid treatment. Our case showed that somatosensory evoked potential study can be an important objective tool in the diagnosis of acute polyneuropathy with normal distal nerve conduction and that corticosteroids should be considered in the initial treatment of GBS-resembling polyneuropathy associated with nephrotic syndrome.

Keyword

Acute sensorimotor polyneuropathy; nephrotic syndrome; somatosensory evoked potential; conduction block

MeSH Terms

Evoked Potentials, Somatosensory/physiology
Humans
Male
Middle Aged
Nephrotic Syndrome/*diagnosis/*physiopathology
Polyneuropathies/*diagnosis/*physiopathology

Figure

  • Fig. 1 Serial median nerve SSEP studies using the same filter settings. (A) At admission, the observed increased duration of positive deflection with a low amplitude negative peak of the bilateral brachial plexus (Erb's point) with barely discernible cervical and cortical potentials are shown. (B) Restoration of the waveforms of the SSEP, which was evident 5 weeks after corticosteroid treatment, is shown. SSEP, somatosensory evoked potential.


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