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Clinical Pathologic Conference
December 2015

A Young Woman With Blurred Vision and Distal Paresthesias

Author Affiliations
  • 1Department of Neurology, Washington University in St Louis, St Louis, Missouri
  • 2Division of Oncology, Department of Medicine, Washington University in St Louis, St Louis, Missouri
  • 3Department of Pathology and Immunology, Washington University in St Louis, St Louis, Missouri
  • 4Department of Ophthalmology, Washington University in St Louis, St Louis, Missouri
JAMA Neurol. 2015;72(12):1519-1523. doi:10.1001/jamaneurol.2015.2390
Abstract

A 29-year-old woman presented with blurred vision and distal paresthesias. Her initial evaluation revealed severe bilateral optic disc edema with distal lower-extremity sensory and motor deficits and electrodiagnostic evidence of a length-dependent mixed demyelinating and axonal polyneuropathy. The results of routine diagnostic testing, including laboratory tests, magnetic resonance imaging, and lumbar puncture, were nondiagnostic. A targeted biopsy was ultimately required for diagnosis. In this article, we discuss the differential diagnosis and outline the clinical evaluation indicated for a patient presenting with demyelinating polyneuropathy and concurrent papilledema.

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