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Currently filtering by tag: Myelin

Multiple Mononeuropathy

Multiple mononeuropathy
This 25-year-old patient presented with clinical features of mononeuropathy multiplex (multifocal neuropathy). Serologic studies showed normal inflammatory markers. The nerve biopsy was performed to evaluate for vasculitis. The patient was treated with steroids prior to biopsy.   Based on the following images (see Figures 1 – 5) what additional testing would be most warranted? A. ANCA B. Del/Dup PMP22 C. Amyloid subtyping D. Hemoglobin A1C   Note the two axons that appear enlarged (thick arrows) compared to other myelinated axons within the nerve fascicle   Note the several axons have thicker myelin sheaths (thick arrows) compared to other large-diameter myelinated...

Peripheral Nerve Myelinating Cells

Schwann Cell
Figure 1 shows a myelin sheath (arrow) with orderly myelin wrapping. No abnormality of myelin periodicity is seen (i.e. no widely spaced or uncompact myelin is observed). No morphologic evidence to suggest a paraproteinopathy is identified. Original magnification:  Electron microscopy, 20K.    A 55-year-old female patient presents with lower extremity weakness and numbness in her feet. Her medication list includes insulin. EMG/NCS showed electrodiagnostic evidence of denervation-type change.  A biopsy of the sural nerve was performed.  Neuropathologic review showed moderate to marked axonopathic changes characterized by relatively diffuse axonal loss, consistent with diabetic polyneuropathy.  After reviewing Figure 1, which cell...