Acquired ataxic neuropathies are uncommon but dramatic disorders. The differential diagnosis is approached by a branching scheme based on the electrophysiologic findings. Individuals with normal sensory nerve action potentials (SNAP’s) can be evaluated for dorsal radiculopathies, myelopathies masquerading as neuropathies, or hysteria. Findings indicative of demyelination are seen in some rare cases of acute and chronic inflammatory demyelinating neuropathies and in the neuropathy associated with IgM paraproteins that recognize epitopes of the myelin-associated glycoprotein and some nerve glycolipids (“anti-MAG antibodies”). Sensory axonal neuropathies with ataxia include the toxic neuropathies due to pyridoxine, cis-platinum, taxol, metronidazole, and some cases of metal poisoning. The most frequent and prevalent group is comprised of the sensory neuronopathies that occur in the setting of lymphocytic sensory ganglionitis. This group includes idiopathic sensory ganglionitis, sensory ganglionitis associated with features of Sjogren’s syndrome, and carcinomatous sensory neuronopathy. Most patients with acquired ataxic neuropathies can be accurately diagnosed. Their treatment varies with the etiology, but the prognosis for recovery of function through relearning and compensatory mechanisms is often surprisingly good.
KeywordsDorsal Root Ganglion Autonomic Neuropathy Sensory Neuropathy Nerve Biopsy Chronic Inflammatory Demyelinating Polyneuropathy
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