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Peripheral and central nerve conduction in subacute myelo-optico-neuropathy

Departments of Neurology (Drs. Shibasaki, Kakigi, and Kuroiwa) and Neuropathology (Dr. Ohnishi), Neurological Institute, Faculty of Medicine, Kyushu University 60, Fukuoka City, Japan.

Five patients with subacute myelo-optico-neuropathy (SMON) were studied by short-latency somatosensory evoked potentials (SEPs) in response to electrical stimulation of the median nerve and the posterior tibial nerve. SEPs with median nerve stimulation were normal in all cases, but SEPs with posterior tibial nerve stimulation were abnormal in two patients with severe sensory loss in the legs. Abnormalities suggested normal peripheral conduction but a marked attenuation of the cortical component and delayed central conduction. These findings were in conformity with postmortem morphometric analysis, which showed marked reduction of myelinated fibers in the gracile fascicle but only slight reduction of large myelinated fibers in the sural nerve. The pathophysiology of SMON appears to be mainly a central distal axonopathy.

Address correspondence and reprint requests to Dr. Shibasaki, Department of Internal Medicine, Saga Medical School, Nabeshima, Saga City 840-01, Japan.

This paper was presented at the Symposium of the tenth International Congress of EEG and Clinical Neurophysiology, Kyoto, Japan, September 1981.

Accepted for publication March 9, 1982.

This article has been cited by other articles:

				H. Tomoda, H. Shibasaki, I. Hirata, and K. Oda Central vs Peripheral Nerve Conduction: Before and After Treatment of Subacute Combined Degeneration Arch Neurol, May 1, 1988; 45(5): 526 - 529. [Abstract] [PDF]