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Atypical Presentation of Hereditary Neuropathy with Liability to Pressure Palsy: A Case Report

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초록

Hereditary neuropathy with liability to pressure palsy (HNPP) is an autosomal dominant peripheral nerve disorder that typically presents clinically as recurrent painless numbness and weakness at the entrapment site or areas susceptible to pressure. Less commonly, the disorder may clinically present as progressive polyneuropathy, chronic polyneuropathy, Charco-Marie- Tooth disease-like symptoms, or chronic inflammatory demyelinating polyneuropathy-like disorder. One case has been reported in which HNPP presented as progressive muscular atrophy in old age. Herein, we report a late-onset HNPP patient who presented with slowly progressing lower motor neuron-predominant motor neuron disease, which resulted in death due to bulbar dysfunction 7 years post-diagnosis. Therefore, we propose that the clinical spectrum of HNPP may be broader than current reports suggest.

Abstract

Hereditary neuropathy with liability to pressure palsy (HNPP) is an autosomal dominant peripheral nerve disorder that typically presents clinically as recurrent painless numbness and weakness at the entrapment site or areas susceptible to pressure. Less commonly, the disorder may clinically present as progressive polyneuropathy, chronic polyneuropathy, Charco-Marie- Tooth disease-like symptoms, or chronic inflammatory demyelinating polyneuropathy-like disorder. One case has been reported in which HNPP presented as progressive muscular atrophy in old age. Herein, we report a late-onset HNPP patient who presented with slowly progressing lower motor neuron-predominant motor neuron disease, which resulted in death due to bulbar dysfunction 7 years post-diagnosis. Therefore, we propose that the clinical spectrum of HNPP may be broader than current reports suggest.

참고문헌 (10)

  1. Chance PF, "Overview of hereditary neuropathy with liability to pressure palsies", Ann N Y Acad Sci, 883, pp.14~21 (1999)
  2. Mouton P, "Spectrum of clinical and electrophysiologic features in HNPP patients with the 17p11.2 deletion", Neurology, 52, pp.1440~1446 (1999)
  3. Tohge R, "Case of hereditary neuropathy with liability to pressure palsies presenting progressive muscular atrophy with lower motor neuron degeneration in the spinal cord and the brainstem", Neurol Clin Neurosci, 4, pp.19~21 (2016)
  4. Korn-Lubetzki I, "Family with inflammatory demyelinating polyneuropathy and the HNPP 17p12 deletion", Am J Med Genet, 113, pp.275~278 (2002)
  5. Luigetti M, "Clinical, neurophysiological and pathological findings of HNPP patients with 17p12 deletion : a single-centre experience", J Neurol Sci, 341, pp.46~50 (2014)
  6. Yilmaz U, "Pain in hereditary neuropathy with liability to pressure palsy: an association with fibromyalgia syndrome?", Muscle Nerve, 51, pp.385~390 (2015)
  7. Choi YH, "Low back pain with radicular symptoms as a presentation of hereditary neuropathy with liability to pressure palsies : the diagnostic challenge of an atypical presentation", Muscle Nerve, 53, pp.655~656 (2016)
  8. Bhatt A, "Hereditary neuropathy with liability to pressure palsies and amyotrophic lateral sclerosis", Neurol Sci, 30, pp.241~245 (2009)
  9. Choi K, "Spinobulbar muscular atrophy combined with atypical hereditary neuropathy with liability to pressure palsy", J Clin Neurosci, 48, pp.90~92 (2018)
  10. Li J, "The PMP22 gene and its related diseases", Mol Neurobiol, 47, pp.673~698 (2013)

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