(Sub)Acute Sensory Neuropathy

• Clinical
• Onset
• Over Days to Weeks
• Paresthesias & Pain
• Pansensory loss
• Proximal + Distal
• Autonomic dysfunction: Mild
• Motor: Normal; Occasional mild weakness
• Tendon reflexes
• Usually absent
• Rare patients may have preserved tendon reflexes
• ? Central branch of sensory neuron damaged rather than cell body
• ? Preserved Ia afferents to motor neurons
• Prognosis: Often incomplete recovery
• Idiopathic: ? GBS-like syndrome
• Differential Diagnosis
• Paracarcinomatous (anti-Hu antibodies)
• Sj–gren's (SSA or SSB antibodies)
• GD1b antibodies: Acute or Relapsing
• Toxic: Cis-platinum; Pyridoxine intoxication
• Laboratory
• Nerve conduction studies
• Sensory potential amplitudes: Usually absent; May be reduced or normal
• Conduction velocities: Relatively normal
• Nerve biopsy: Axonal loss; Mild inflammation
• Epstein-Barr virus titers elevated in some patients