Skip to main content
Log in

Chronic progressive sensory ataxic neuropathy: clinicopathological features of idiopathic and Sjögren's syndrome-associated cases

  • Original Communications
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Eleven patients with chronic progressive sensory ataxic neuropathy were examined clinicopathologically. Three cases were associated with primary Sjögren's syndrome (SS-SAN) and the others were considered to be idiopathic (ISAN). The major clinical symptom in both was loss of proprioceptive and kinesthetic sensation with some impairment of superficial sensation, with multifocal and asymmetrical distribution and progression. The truncal and trigeminal nerves were frequently involved. The motor system was substantially preserved. These somatic sensory and motor symptoms did not differ between ISAN and SS-SAN, but autonomic nervous system signs were more frequent in SS-SAN. Polyclonal elevations of serum IgG and/or IgA were seen in 8 patients. One autopsied case with ISAN combined with previous reports suggested that systemic T-and B-cell infiltration into the nervous tissues, as well as a wide variety of the visceral organs, may be a common finding in ISAN and SS-SAN, and could participate in the cause of this neuropathy and polyclonal hypergammaglobulinaemia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Adamson T, Fox R, Frisman D, Howell F (1983) Immunohistologic analysis of lymphoid infiltrates in primary Sjögrens syndrome using monoclonal antibodies. J Immunol 130:203–208

    Google Scholar 

  2. Alexander EL, Arnett FC, Provost TT, Stevens MB (1983) Sjögren's syndrome: association of anti-Ro (SS-A) antibodies with vasculitis, hematologic abnormalities, and serologic hyperreactivity. Ann Intern Med 98:155–159

    Google Scholar 

  3. Dalakas M (1986) Chronic idiopathic ataxic neuropathy. Ann Neurol 19:545–554

    Google Scholar 

  4. Dalakas MC, Engel WK (1981) Polyneuropathy with monoclonal gammopathy: studies of 11 patients. Ann Neurol 10:45–52

    Google Scholar 

  5. Denny-Brown D (1948) Primary sensory neuropathy with muscular changes associated with carcinoma. J Neurol Neurosurg Psychiatry 11:73–87

    Google Scholar 

  6. Fox RI, Robinson CA, Curd JG, et al (1986) Sjögren's syndrome, proposed criteria for classification. Arthritis Rheum 29:577–585

    Google Scholar 

  7. Graus F, Pou A, Kanterewizc E, Anderson NE (1988) Sensory neuronopathy and Sjögren's syndrome: clinical and immunologic study of two patients. Neurology 38:2637–2639

    Google Scholar 

  8. Griffin JW, Cornblath DR, Alexander E, Campbell J, Low PA, Bird S, Feldman EL (1990) Ataxic sensory neuropathy and dorsal root ganglionitis associated with Sjögren's syndrome. Ann Neurol 27:304–315

    Google Scholar 

  9. Hadley D, Herr HW (1979) Peripheral neuropathy associated with cisdichlor diamminoplatinum (II) treatment. Cancer 44:2026–2032

    Google Scholar 

  10. Hankey GJ, Gubbay SS (1987) Peripheral neuropathy associated with sicca syndrome. J Neurol Neurosurg Psychiatry 50:1085

    Google Scholar 

  11. Hodson AK, Hurwitz BJ, Albrecht R (1984) Dysautonomia in Guillain-Barré syndrome with dorsal root ganglioneuropathy, Wallerian degeneration, and total myocarditis. Ann Neurol 15:88–95

    Google Scholar 

  12. Horowich MS, Cho L, Porro RS, Posner JB (1977) Subacute sensory neuropathy: a remote effect of carcinoma. Ann Neurol 2:7–19

    Google Scholar 

  13. Kaltreider HB, Talal N (1969) The neuropathy of Sjögren's syndrome: trigeminal nerve involvement. Ann Intern Med 70:751–762

    Google Scholar 

  14. Kaufman MD, Hopkins LC, Hurwitz BJ (1981) Progressive sensory neuropathy in patients without carcinoma: a disorder with distinctive clinical and electrophysiological findings. Ann Neurol 9:237–242

    Google Scholar 

  15. Kennett RP, Harding AE (1986) Peripheral neuropathy associated with the sicca syndrome. J Neurol Neurosurg Psychiatry 49:90–92

    Google Scholar 

  16. Laloux P, Brucher JM, Guerit JM, et al (1988) Subacute sensory neuronopathy associated with Sjögren's sicca syndrome. J Neurol 235:352–354

    Google Scholar 

  17. Malinow K, Yannakakis GD, Glosman SM, et al (1986) Subacute sensory neuropathy secondary to dorsal root ganglionitis in primary Sjögren's syndrome. Ann Neurol 20:535–537

    Google Scholar 

  18. Mason DY, Comans-Bitter WM, Cordell JL, Verhoeven MAJ, Dongen JJM van (1990) Antibody L26 recognizes an intracellular epitope on the B-cell-associated CD 20 antigen. Am J Pathol 136:1215–1222

    Google Scholar 

  19. Mellgren SI, Conn DL, Stevens JC, Dyck PJ (1989) Peripheral neuropathy in Sjögren's syndrome. Neurology 39:390–394

    Google Scholar 

  20. Mitsumoto H, Wilbourn AJ, Massarweh W (1985) Acquired “pure” sensory polyneuropathy (APSP): unique clinical features in 30 patients (abstract). Neurology 35[Suppl 1]:295

    Google Scholar 

  21. Nemni R, Galassi G, Latov N, Sherman WH, Olarte MR, Hays AP (1983) Polyneuropathy in nonmalignant Ig M plasma cell dyscrasia: a morphological study. Ann Neurol 14:43–54

    Google Scholar 

  22. Norton AJ, Isaacson PG (1987) Monoclonal antibody L26: an antibody that is reactive with normal and neoplastic B lymphocytes in routinely fixed and paraffin wax embeded tissues. J Clin Pathol 40:1405–1412

    Google Scholar 

  23. Norton AJ, Ramsay AD, Smith SH, Beverley PCL, Isaacson PG (1986) Monoclonal antibody (UCHL-1) that recognizes normal and neoplastic T cells in routinely fixed tissues. J Clin Pathol 39:399–405

    Google Scholar 

  24. Osame M, Igata A, Matsumoto M (1989) HTLV-I associated myelopathy (HAM) revised. In: Roman GC, Vernant J-C, Osame M (eds) HTLV-I and the nervous system. Liss, New York, pp 213–223

    Google Scholar 

  25. Pulford KAF, Rigney EM, Micklem KJ, Jones M, Stross WP, Catter KC, Mason DY (1989) KP1: a new monoclonal antibody that detects a monocyte/macrophage associated antigen in routinely processed tissue sections. J Clin Pathol 42:414–421

    Google Scholar 

  26. Research Committee of Sjögren's Syndrome (1977) Diagnostic criteria for Sjögren's syndrome. Annual Report on Research for Intractable Disease. Ministry of Health and Welfare of Japan, Tokyo

    Google Scholar 

  27. Richter RB (1962) The ataxic form of polyradiculoneuritis (Landry-Guillain-Barrè syndrome): clinical and pathological observations. J Neuropathol Exp Neurol 21:171–184

    Google Scholar 

  28. Schaumburg G, Kaplan J, Windebank A, et al (1983) Sensory neuropathy from pyridoxine abuse: a new megavitamin syndrome. N Engl J Med 309:445–448

    Google Scholar 

  29. Simon LT, Ricaurte GA, Forno LS (1989) Chronic idiopathic ataxic neuropathy: neuropathology of a case. Acta Neuropathol 79:104–107

    Google Scholar 

  30. Sobue G, Senda Y, Matsuoka Y, Sobue I (1983) Sensory ataxia: a residual disability of Guillain-Barré syndrome. Arch Neurol 40:86–89

    Google Scholar 

  31. Sobue G, Yanagi T, Hashizume Y (1988) Chronic progressive sensory ataxic neuropathy with polyclonal gammopathy and disseminated focal perivascular cellular infiltrations. Neurology 38:463–467

    Google Scholar 

  32. Sobue G, Yasuda T, Mitsuma T, Ross AH, Pleasure D (1988) Expression of nerve growth factor receptor in human peripheral neuropathies. Ann Neurol 24:64–72

    Google Scholar 

  33. Sobue G, Hashizume Y, Mukai E, Hirayama M, Mitsuma T, Takahashi A (1989) X-linked recessive bulbospinal neuronopathy: a clinicopathological study. Brain 112:209–232

    Google Scholar 

  34. Sobue G, Ibi T, Matsuoka Y, Yanagi T, Mitsuma T (1989) Clinical features of the peripheral nerve involvement in necrotizing angitis: characteristics in polyarteritis nodosa and allergic granulomatous angitis (in Japanese). Clin Neurol (Tokyo) 29:40–48

    Google Scholar 

  35. Sterman AB, Schaumberg HH, Asbury AK (1980) The acute sensory neuronopathy syndrome: a distinct clinical entity. Ann Neurol 7:354–358

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sobue, G., Yasuda, T., Kachi, T. et al. Chronic progressive sensory ataxic neuropathy: clinicopathological features of idiopathic and Sjögren's syndrome-associated cases. J Neurol 240, 1–7 (1993). https://doi.org/10.1007/BF00838437

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00838437

Key words

Navigation