J Clin Neurol.  2018 Jan;14(1):73-80. 10.3988/jcn.2018.14.1.73.

Partial Conduction Block as an Early Nerve Conduction Finding in Neurolymphomatosis

Affiliations
  • 1Department of Neurology, Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Korea. pkd1165@ewha.ac.kr
  • 2Department of Neurology, Yonsei University College of Medicine, Seoul, Korea. kimsm@yuhs.ac
  • 3Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND
AND PURPOSE: Neurolymphomatosis is a rare manifestation of hematological malignancy and is characterized by direct infiltration of the peripheral nervous system. The objective of this study was to identify the clinical and electrophysiological features of neurolymphomatosis.
METHODS
We retrospectively analyzed the medical records of 13 patients with neurolymphomatosis. Seven (54%) of the patients were men, and the median age at symptom onset was 60.0 years.
RESULTS
The most common type of underlying malignancy was diffuse large B-cell lymphoma (69%). Twelve patients had painful asymmetric neuropathies. The median survival time after diagnosis was 7 months, and 12 patients died during the study period. Thirty-eight motor nerve conduction studies (NCSs) were performed in the affected nerves. Ten and 28 motor nerves were classified into the conduction-block and simple-axon-degeneration groups, respectively. The median time interval between symptom onset and the NCS was significantly shorter in the conduction-block group than in the simple-axon-degeneration group (p=0.032). However, no significant differences in the motor nerve conduction velocities, terminal latencies, and distal compound muscle action potential amplitudes were identified between the conduction-block and simple-axon-degeneration groups. The conduction-block group showed excessive temporal dispersion in only five of the ten NCSs (50%). Follow-up NCSs revealed that partial conduction blocks had changed into axonal degeneration patterns.
CONCLUSIONS
This is the first study to analyze the electrophysiological features of patients with neurolymphomatosis. Our findings showed that a partial conduction block is not rare and is an early nerve conduction abnormality in neurolymphomatosis.

Keyword

neurolymphomatosis; lymphoma; leukemia; nerve conduction study; conduction block
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