title: Errors in diagnosis of polyneuropathy: three cases of chronic lumbosacral root impairment.
abstract: In the last years very precise diagnostic investigations have been introduced to allow accurate diagnosis of pathologies affecting the major part of peripheral nerves; nevertheless, some avoidable misdiagnosis still occurs. For instance, the neurophysiological pattern observed in chronic compression of nerve roots may mimic an axonal polyneuropathy, especially when compression occurs in post-ganglionic tract of dorsal root (in this case sensory nerve conduction studies show decreased or absent response). A clinical-neurophysiological dissociation may be noted in cases with pre-ganglionic impairment of dorsal root (clinical sensory deficit in presence of normal amplitude of sensory response). During the past two years we observed 3 cases with diagnosis of polyneuropathy that, after further studies, appeared affected by severe chronic compression of lumbo-sacral nerve roots. Our data suggest that in those cases with suspected polyneuropathy, in which the neurophysiological picture is characterized by the exclusive axonal (and myelinic) involvement of motor and/or sensory peripheral nerve of lower limbs, neuroimaging of radicular structures must be performed. These further investigations may avoid severe and irreversible damage to neural tissues.
authors.affiliation: Department of Neurology, Università Cattolica, Rome, Italy. lpadua@mclink.it
authors.forename: L
authors.initials: L
authors.lastname: Padua
authors.forename: R
authors.initials: R
authors.lastname: Padua
authors.forename: M
authors.initials: M
authors.lastname: Nazzaro
authors.forename: P
authors.initials: P
authors.lastname: Tonali
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D006801:Humans; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000175:diagnosis; D011115:Polyneuropathies / Q000175:diagnosis*; D013126:Spinal Nerve Roots / Q000473:pathology