Imaging Studies:
Electromyography and nerve conduction studies showdemyelinating form of slow driving. All nerves test shows the samelow speed driving. The neuronal forms of nerve conduction velocityis normal, but small amplitude sensitive. It is obvious insetionaleincreased activity and fibrillation potentials. Neuropathic motor unitshows the changes in morphology.
Histological examination: disease type 1 in peripheral nervescontain few myelinated fibers, and the intramuscular connectivetissue are surrounded by rich and neurilema hyperplasia. Myelin isalong the atrophic fibers. Describe the leaf sheath concentrichypertrophy. Note the typical onion bulb formation with concentricproliferation of Schwann cells. In type 2 describes axonaldegeneration in type 3 demyelination and thinner myelin sheath.No inflammatory infiltrates are described to indicate ademyelinating autoimmune process.
The differential diagnosis is made with the following conditions:alcoholism, HIV infection, leprosy, neurosyphilis, vitamin B12deficiency, thyroid disease, diabetes, vascultita, amyloidosis,occult malignancy, heavy metal poisoning, chronic inflammatory demyelinating polyneuropathy, ataxia Friedrich.
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