A Young Woman With Blurred Vision and Distal Paresthesias.
A 29-year-old woman presented with blurred vision and distal paresthesias. Her initial evaluation revealed severe bilateral optic disc edema with distal lower-extremity sensory and motor deficits and electrodiagnostic evidence of a length-dependent mixed demyelinating and axonal polyneuropathy. The results of routine diagnostic testing, including laboratory tests, magnetic resonance imaging, and lumbar puncture, were nondiagnostic. A targeted biopsy was ultimately required for diagnosis. In this article, we discuss the differential diagnosis and outline the clinical evaluation indicated for a patient presenting with demyelinating polyneuropathy and concurrent papilledema.
Department of Neurology, Washington University in St Louis, St Louis, Missouri.
Nathan H
NH
Kung
Division of Oncology, Department of Medicine, Washington University in St Louis, St Louis, Missouri.
Nancy L
NL
Bartlett
Department of Pathology and Immunology, Washington University in St Louis, St Louis, Missouri.
Nabeel R
NR
Yaseen
Department of Neurology, Washington University in St Louis, St Louis, Missouri4Department of Ophthalmology, Washington University in St Louis, St Louis, Missouri.
Gregory P
GP
Van Stavern
Department of Neurology, Washington University in St Louis, St Louis, Missouri.
Robert C
RC
Bucelli
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D010292:Paresthesia / Q000150:complications* / Q000175:diagnosis*; D015898:Tomography Scanners, X-Ray Computed; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D014786:Vision Disorders / Q000150:complications* / Q000175:diagnosis*
D042461:Vascular Endothelial Growth Factor A