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Case Reports
. 2016 Mar 11;4(1):100-104.
doi: 10.1002/mdc3.12336. eCollection 2017 Jan-Feb.

Multifocal Motor Neuropathy Presenting as Pseudodystonia

Nidhi Garg  1 , Robert N S Heard  2 , Lynette Kiers  3 , Richard Gerraty  4 , Con Yiannikas  5   6
Affiliations
Case Reports

Multifocal Motor Neuropathy Presenting as Pseudodystonia

Nidhi Garg et al. Mov Disord Clin Pract. .

Abstract

Multifocal motor neuropathy (MMN) is an immune-mediated neuropathy. Wasting and weakness typically dominate the clinical presentation. We describe four cases presenting with prominent cramping resembling a primary movement disorder. All cases had features of focal motor conduction block on neurophysiological studies. The involuntary movements resolved in all four patients following treatment with intravenous immunoglobulin. The presented cases highlight an unusual presentation of MMN and emphasize that peripheral nerve pathology can present with movement disorders mimicking central nervous system disease. Furthermore, the movement disorder appears particularly sensitive to standard therapy.

Keywords: conduction block; cramping; dystonia; multifocal motor neuropathy; peripheral nerve hyperexcitability.

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Figures

Figure 1
Figure 1
Neurophysiology. Nerve conduction studies. Case 1: focal motor conduction block in the forearm segment of the median nerve (A) with resolution following treatment with intravenous immunoglobulin (B). Case 3: bilateral conduction block in the forearm segment of the median nerves (C and D). Case 2: proximal median nerve conduction block between Erb's point and the axilla (E). W, wrist; E, elbow; A, axilla; EP, Erb's point; IVIg, intravenous immunoglobulin; APB, abductor pollicis brevis; a = amplitude; A = negative peak area; d = negative peak duration.
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