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July 2007

Dwindling Indications for Sural Nerve Biopsy

Arch Neurol. 2007;64(7):935-936. doi:10.1001/archneur.64.7.935

This issue of the Archives contains 3 articles on the etiology and pathophysiology of peripheral neuropathies: acquired forms related to eosinophilia; Charcot-Marie-Tooth disease (CMT) associated with neurofilament light chain gene (NEFL) mutations; and hereditary predisposition to pressure palsies (HNPP). Chao et al1 report on 12 patients with eosinophilia and the subacute onset of sensorimotor polyneuropathy or mononeuropathy multiplex. Six of the 12 met criteria from the American College of Rheumatology for Churg-Strauss syndrome, including adult-onset asthma and/or sinusitis,2 while the remaining 6 had primary eosinophilia. Skin biopsies revealed perivascular infiltrates of eosinophils, lymphocytes and monocytes, and a reduction in nerve fiber density.

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