Kido Keisuke, Wada Shinichi, Oka Yuwa, Terada Yuta, Inoue Manabu, Hamano Toshiaki
Center for Sleep-related Disorders, Kansai Electric Power Hospital, Osaka, Japan.
Division of Sleep Medicine, Kansai Electric Power Medical Research Institute, Osaka, Japan.
Clin Neurophysiol Pract. 2021 Jun 16;6:191-193. doi: 10.1016/j.cnp.2021.05.003. eCollection 2021.
Multifocal motor neuropathy (MMN) occasionally presents with cranial nerve involvement. However, no MMN cases with visual pathway impairment demonstrated by visual evoked potential (VEP) have been reported.
A 36-year-old man was admitted to our hospital with progressive muscular weakness. On admission, neurological findings revealed bilateral muscle weakness and atrophy of the distal upper limbs. The blood tests were positive for GM-1 ganglioside antibodies. Nerve conduction studies revealed bilateral conduction block in the median nerve. He was diagnosed with MMN. Intravenous immunoglobulin treatment improved muscle weakness and blurred vision, which was not a complaint when he was first seen. Moreover, VEP showed a post-treatment shortening of P100 latency. These treatment effects were consistently observed for 3.5 years.
Our findings suggested that MMN could affect the visual pathway through autoimmune mechanisms.
多灶性运动神经病（MMN）偶尔会出现颅神经受累的情况。然而，尚无视觉诱发电位（VEP）显示视觉通路受损的MMN病例报道。
一名36岁男性因进行性肌无力入院。入院时，神经系统检查发现双侧上肢远端肌肉无力和萎缩。血液检查GM-1神经节苷脂抗体呈阳性。神经传导研究显示正中神经双侧传导阻滞。他被诊断为MMN。静脉注射免疫球蛋白治疗改善了肌无力和视力模糊，而视力模糊在他初诊时并非主诉症状。此外，VEP显示治疗后P100潜伏期缩短。这些治疗效果持续观察了3.5年。
我们的研究结果表明，MMN可能通过自身免疫机制影响视觉通路。
