An unusual case of multifocal motor neuropathy with cranial nerve involvement and hyperreflexia

Abstract

Multifocal motor neuropathy is characterized by progressive, asymmetric weakness of the limbs with persistent conduction blocks (CB). Sensory loss is very rare and it also rarely presents with cranial nerve involvement and hyperreflexia. Here we described a 32-year-old woman with progressive weakness of hand muscles associated with weakness of orbicularis oculi muscles and fasciculations of tongue. The electrophysiological examination revealed persistent conduction blocks in both of the ulnar, right median and left posterior tibial nerves together with F-waves with abnormal persistence. These findings and the persistency of conduction blocks along with a response to IVIG made it likely that the diagnosis was multifocal motor neuropathy. The case seemed to be worth reporting because of her unusual clinical findings.