Immunotherapy-responsive allodynia due to distal acquired demyelinating symmetric (DADS) neuropathy

Teerin Liewluck, Janean K. Engelstad, Michelle L. Mauermann

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Introduction: Distal acquired demyelinating symmetric (DADS) neuropathy is a distal variant of chronic inflammatory demyelinating polyradiculoneuropathy. It is characterized by chronic distal symmetric sensory or sensorimotor deficits. Sensory ataxia is a common clinical presentation. Nerve conduction studies typically show markedly prolonged distal motor latencies. Methods: We report 2 patients with chronic progressive generalized pain and fatigue, with normal neurological examinations except for allodynia. Results: Nerve conduction studies were typical of DADS neuropathy. Monoclonal protein studies were negative. Cerebrospinal fluid protein levels were elevated. Sural nerve biopsies revealed segmental demyelination and remyelination. One biopsy had marked endoneurial and epineurial lymphocytic infiltration. Immunomodulatory therapy alleviated the pain and fatigue and markedly improved distal motor latencies in both patients. Conclusions: DADS neuropathy can present with pain and a normal neurological examination apart from allodynia. Nerve conduction studies are necessary for diagnosis. These patients respond to immunotherapy better than typical DADS neuropathy patients with sensory ataxia. Muscle Nerve 54: 973–977, 2016.

Original languageEnglish (US)
Pages (from-to)973-977
Number of pages5
JournalMuscle and Nerve
Volume54
Issue number5
DOIs
StatePublished - Nov 1 2016

Keywords

  • CIDP
  • DADS
  • allodynia
  • distal acquired demyelinating symmetric neuropathy
  • sensory CIDP

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)

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