Central nervous system involvement in hereditary neuropathy with liability to pressure palsies: description of a large family with this association.
OBJECTIVE
To describe a large family with hereditary neuropathy with liability to pressure palsies associated with central nervous system demyelination.


METHODS
We examined the 18 members of a pedigree. Genetic analysis was performed on 15 subjects, standard nerve conduction studies on 10 subjects, and brain magnetic resonance imaging studies on 8 subjects.


RESULTS
Hereditary neuropathy with liability to pressure palsies was confirmed in 9 patients of the pedigree. Brain magnetic resonance imaging findings showed multiple areas of demyelination in 6 of 6 affected members and were normal in 2 of 2 healthy relatives. Magnetic resonance imaging abnormalities were predominantly located in the subcortical frontal white matter. All patients had acute and recurrent nerve palsies, while clinical features of central nervous system involvement were not a characteristic of this pedigree.


CONCLUSIONS
We demonstrate that this association, previously reported in sporadic cases, is not coincidental. Therefore, patients with hereditary neuropathy with liability to pressure palsies can present central nervous system white matter lesions, and the role of the PMP22 (peripheral myelin protein 22) gene deletion in the central nervous system should be further studied.
Sanahuja
Jordi
J
Department of Neurology, Hospital Universitari Arnau de Vilanova, Lleida, Spain.
Franco
Elena
E
Rojas-García
Ricardo
R
Gallardo
Eduard
E
Combarros
Onofre
O
Begué
Robert
R
Granés
Pilar
P
Illa
Isabel
I
D000328:Adult; D002490:Central Nervous System / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D002886:Chromosomes, Human, Pair 17 / Q000235:genetics*; D004252:DNA Mutational Analysis; D005192:Family Health; D005260:Female; D017353:Gene Deletion; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005820:Genetic Testing; D020279:Hereditary Central Nervous System Demyelinating Diseases / Q000235:genetics / Q000473:pathology* / Q000503:physiopathology; D015417:Hereditary Sensory and Motor Neuropathy / Q000150:complications / Q000235:genetics / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D009185:Myelin Proteins / Q000235:genetics*; D009413:Nerve Fibers, Myelinated / Q000378:metabolism / Q000473:pathology*; D009431:Neural Conduction / Q000235:genetics; D010375:Pedigree; D010525:Peripheral Nerves / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology
D009185:Myelin Proteins; C073687:PMP22 protein, human