Ismail Husameldein, Anand Bawani, Hughes Tom, Thomas Benny
Clinical Neurophysiology, University Hospital of Wales, Cardiff, GBR.
Neurology, University Hospital of Wales, Cardiff, GBR.
Cureus. 2024 Dec 20;16(12):e76077. doi: 10.7759/cureus.76077. eCollection 2024 Dec.
Charcot-Marie-Tooth disease (CMT) is the most common hereditary peripheral neuropathy. It presents a wide range of genetic and phenotypic heterogeneity. CMT disease type 1A (CMT1A), caused by PMP22 gene duplication, represents the most common subtype of CMT in Western countries. It usually presents insidiously with stigmata of chronic neuropathy. We report a rare case of CMT1A, which presents acutely in the postpartum period. A young woman who experienced acute bilateral lower limb numbness and weakness post-caesarean section, which was initially attributed to spinal anaesthesia. The initial work-up was normal, but subsequent nerve conduction studies indicated a possibility of hereditary, demyelinating sensory-motor neuropathy. Genetic testing confirmed the diagnosis of CMT1A. The article explores the effects of pregnancy on patients with CMT in terms of potential worsening or unmasking of CMT symptoms and the development of obstetric complications in these patients. It also sheds some light on the role of electrophysiological studies and various biomarkers to differentiate between acquired and hereditary neuropathy. In conclusion, it emphasizes the importance of considering hereditary neuropathies in the differential diagnosis of acute atypical neurological presentation during the postpartum period.
夏科-马里-图思病(CMT)是最常见的遗传性周围神经病。它呈现出广泛的遗传和表型异质性。由PMP22基因重复引起的1A型CMT病(CMT1A)是西方国家最常见的CMT亚型。它通常隐匿起病,伴有慢性神经病的体征。我们报告一例罕见的产后急性起病的CMT1A病例。一名年轻女性在剖宫产术后出现急性双侧下肢麻木和无力,最初被归因于脊髓麻醉。初始检查结果正常,但随后的神经传导研究提示可能为遗传性脱髓鞘感觉运动神经病。基因检测确诊为CMT1A。本文探讨了妊娠对CMT患者的影响,包括CMT症状可能加重或显现,以及这些患者产科并发症的发生情况。文章还阐述了电生理研究和各种生物标志物在鉴别获得性和遗传性神经病方面的作用。总之,强调了在产后急性非典型神经表现的鉴别诊断中考虑遗传性神经病的重要性。