HISTOPATHOLOGICAL EVALUATION OF INFLAMMATORY AND HEREDITARY DEMYELINATING POLYNEUROPATHIES

In view of therapeutic implications and problems in clinical diagnosis , this study sought to evaluate and identify histopathological feature s of acquired inflammatory demyelinating neuropathies and hereditary d emyelinating neuropathies. Sural nerve biopsies from 41 patients of de myelinating neuropathies, diagnosed on the basis of accepted clinical criteria, were studied using routine histological staining and special stains for myelin and axons. Chronic inflammatory neuropathies differ ed from the acute ones in having more endoneurial connective tissue, l ess of subperineurial oedema and presence of axonal sprouting and occa sional onion bulb formation. Acquired neuropathies differed from hered itary neuropathies in having a more localized involvement, endoneurial oedema and variable inflammatory cell infiltration, while in heredita ry neuropathies Schwann cell proliferation was diffuse and relatively uniform. The frequency and degree of nerve thickening was more in here ditary neuropathy. Evidence of inflammation was not universal, both in the acute and the chronic inflammatory demyelinating neuropathies. Hi stopathological examination is essential as the clinical and electroph ysiological features alone may not offer definitive diagnosis.