Chronic axonal sensory and autonomic polyneuropathy without motor involvement: a new 'chronic inflammatory neuropathy?'

We report the case of a woman with axonal sensory and autonomic neuropathy lasting several months who improved in association with steroid administrat ion. During the course of her disease and in the follow-up, the patient und erwent repeated cerebrospinal fluid (CSF) examinations, neurophysiological somatic, autonomic nervous system studies and sural nerve biopsy Clinical a nd laboratory assessments demonstrated the occurrence of a monophasic, chro nic sensory and autonomic neuropathy. A sural nerve biopsy suggested an axo nopathy. After a progressive worsening of symptoms lasting about 6 months, steroid treatment was started and within 6 months a complete recovery with normalization of the CSF findings, was observed. Although the 'chronic infl ammatory neuropathies' are still debated entities, the features of this chr onic, exclusively sensory and autonomic neuropathy are new, and the occurre nce of a high protein level in the CSF, together with the favorable outcome associated with steroid treatment, suggests that our case might be another variant in this debated area, Eur J Neurol 6:249-253 (C) 1999 Lippincott W illiams & Wilkins.