P.058 Length dependent sensorimotor peripheral neuropathy often results in ventral abdominal sensory loss

Abstract

Background: Length-Dependent Sensorimotor Peripheral Neuropathy (LDSMPN) affects the longest nerve fibers in the body. Less well-appreciated, and absent from the current literature, is that LDSMPN affecting thoracic segments gives rise to ventral abdominal sensory loss on clinical exam. Methods: Consecutive patients seen for LDSMPN (n=30) were evaluated prospectively for the presence or absence of ventral abdominal sensory loss. Demographic variables, symptoms, quantitative neurologic findings (Neuropathy Impairment Score [NIS]) and final diagnosis were examined using descriptive statistics. Results: Ventral abdominal sensory loss was documented in 20/30 LDSMPN patients (66.7%), mean age was 64.1 years (range 33-81), M:F gender ratio was 19:11, mean NIS was 21.4 (range 0-77). NCS/EMG abnormalities were found in 25/30 patients, with 5/30 having a clinical exam and/or other electrophysiological evidence convincing for LDSMPN. LDSMPN patients without ventral abdominal sensory loss (n=10) had a mean age of 61.2 (range 45-73), M:F of 7:3, and mean NIS of 20.9 (range 0-54). Conclusions: 1) Ventral abdominal sensory loss appears to be common in patients diagnosed with LDSMPN of a variety of causes; 2) in addition to those innervating distal limb territories, distal sensory fibers from the thoracic region represent another category of length dependent involvement in LDSMPN; 3) the clinical examination of LDSMPN should include the ventral abdomen.