Journal
REVUE NEUROLOGIQUE
Volume 173, Issue 10, Pages 650-657Publisher
MASSON EDITEUR
DOI: 10.1016/j.neurol.2017.05.007
Keywords
Maladie de Fabry; Neuropathie; Neuropathie des petites fibres; Hypohydrose; Acrosyndrome
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Background. - Peripheral nerve system (PNS) involvement is commonin Fabry's disease (FD), predominantly affecting the small nerve fibers that are difficult to investigate with conventional electrophysiological methods. Patients and methods. - Eighteen patients followed for Fabry's disease underwent a prospective series of electroneurophysiological explorations, including a study of the cardiac parasympathetic autonomic nervous system (ANS) and electrochemical skin conductance (ESC) tests. Data were compared with those obtained in 18 matched healthy controls. Results. - All patients had at least one clinical sign suggestive of neuropathy: 16 reported an acrosyndrome and 12 had dyshidrosis. Cold hypoesthesia was found in 15 patients and heat hypoesthesia in 13. Electroneurophysiological investigations and study of the cardiac parasympathetic ANS were normal in all patients. The ESC was significantly lower in FD patients compared with controls. Conclusion. - PNS involvement is common in FD and should be suspected in patients exhibiting an acrosyndrome, dyshidrosis and/or cold hypoesthesia. Conventional electrophysiological investigations are normal. New techniques, such as ESC, provide early diagnosis of small fiber involvement that currently requires more sophisticated tests difficult to apply in routine practice. (C) 2017 Elsevier Masson SAS. All rights reserved.
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