Gait Disorder, Autoantibody
Late-age Onset Polyneuropathy
Case Study A
An 82-year-old female presented with progressive gait disorder. For four years, she had experienced numbness and tingling in her toes, followed by unsteadiness of gait and falling. Physical examination showed mild weakness and absent reflexes at the ankles. The patient could not ambulate without support. Electrophysiological findings showed absent sensory nerve action potentials (SNAPs) in the lower extremities with borderline compound muscle action potentials (CMAPs). Laboratory tests for treatable causes of sensory neuropathies, including diabetes, B12, and vitamin E deficiency, were negative. Testing for serum antibodies associated with sensory-motor neuropathies showed high levels of the GALOP autoantibody. One and three months after treatment with IVIg, distal strength was improved.
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