Brain, Vol. 112, No. 1, 209-232, 1989
© 1989 Oxford University Press
research-article |
X-LINKED RECESSIVE BULBOSPINAL NEURONOPATHY
A CLINICOPATHOLOGICAL STUDY
Division of Neurology, Fourth Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, the Departments of Pathology and Neurology, Nagoya University School of Medicine, Nagoya, and the Department of Neurology, Minato-Kyoritsu Hospital Nagoya, Japan
Correspondence to:
Correspondence to: Dr Gen Sobue, Division of Neurology, Fourth Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi 480-11, Japan
A clinicopathological study on X-linked recessive bulbospinal neuronopathy was undertaken on 9 cases, with morphological observations on 3 autopsied cases and sural nerve biopsies from 6 patients. Both lower motor and primary sensory neurons were involved. Lower motor neurons were markedly depleted through all spinal segments and in brainstem motor nuclei except for the third, fourth and sixth cranial nerves. Primary sensory neurons were less severely affected. A quantitative study of primary sensory axons at several levels in the peripheral nervous system suggested that a distally accentuated axonopathy was the salient pathological process. Segmental demyelination and remyelination clustered on individual fibres, and g ratios (axon diameter total fibre diameter) in the sural nerve showed an increased scatter in some cases. Evidence of regeneration was inconspicuous. Unmyelinated fibres were well preserved throughout all the nerves examined. Neurons in the Onufrowicz nuclei, in the intermediolateral columns and in Clarke's columns of the spinal cord were generally well preserved These observations indicate that a lower motor and primary sensory neuronopathy is a major neurological manifestation in this disease.
Received November 16, 1987. Revised May 4, 1988. Accepted May 20, 1988.
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