Neuropathy versus neuronopathy: distinctive features

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Abstract from Rev Med Liege. 2004;59 Suppl 1:208-18.

Neuropathy versus neuronopathy: distinctive features

Magistris MR, Soichot P.

Unite d'Electroneuromyographie et des affections neuromusculaires,

Hopital Universitaire de Geneve, Suisse.

Neuropathy may be difficult to distinguish from neuronopathy, on both

motor and sensory sides. A number of disorders that present with

characteristic electro-clinical features are readily recognized. Except

for those, distinction of the lesions that concern the peripheral nerve

cell or the axon may require support of clinical, electrophysiological

and other ancillary tests. Distinction between motor neuropathy and

neuronopathy can be based on the abnormalities of nerve conduction and

on the signs that relate to the reinnervation process. Signs of terminal

axonal reinnervation, such as motor axon reflex, may be observed in

axonal neuronopathies, whereas only collateral reinnervation occurs in

motor neuronopathies. Sensory axonopathies are usually characterized by

clinical and electrophysiological findings that are axon

length-dependent, by the course of the disorder that is most often

chronic, and by possible reversibility. Sensory neuronopathies are

usually subacute and induce clinical deficits that are more or less

widespread to the whole body surface rather than distal. Follow-up

studies disclose limited or absent recovery. A better knowledge of the

structural differences of motor and sensory neurons and axons will

improve our understanding and lead to the development of specific tests.

Meanwhile, although some parameters and techniques should still be

improved, electrophysiological and additional tests are useful to detect

and to distinguish the peripheral nerve disorders that affect the nerve

cell bodies and their axons.