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multifocal motor neuropathy
Epidemiology:
- adults
Pathology:
- disease of lower motor neurons
Clinical manifestations:
1) asymmetrical muscle weakness
2) fasciculations (often)
3) cramping
4) weakness without objective sensory loss in the distribution of two or more of the following nerves:
a) median nerve
b) ulnar nerve
c) radial nerve
d) peroneal nerve
e) tibial nerve
5) during the early stages of symptomatic weakness, diffuse, symmetric weakness excludes diagnosis
6) absence of each of upper motor neuron signs
7) diagnosis is a difficult one
Special laboratory:
- nerve conduction studies
a) definite conduction block present in 2 or more nerves outside of common entrapment sites
- median nerve at wrist
- ulnar nerve at elbow or wrist
- peroneal nerve at fibular head
b) normal sensory nerve conduction velocity across the same segments with demonstrated motor conduction block.
c) normal results for sensory nerve conduction studies on all tested nerves, with a minimum of 3 nerves tested
General
motor neuropathy