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Introduction: Lewis-Sumner syndrome (LSS)
is a very rare multifocal demyelinating neuropathy,
characterised by an asymmetrical
clinical involvement with weakness and
sensory impairment. Electrophysiological
studies show a reduced conduction velocity
(CV) and conduction blocks (CB). In one
study of patients with LSS the clinically
affected brachial plexus appeared diffusely
swollen on magnetic resonance imaging
(MRI).
Case report:We present a case with typical
asymmetrical clinical symptoms, but the
brachial and lumbar plexus involvement on
MRI was symmetrical. The weakness, affecting
the proximal left arm and the distal right
leg, was asymmetrical as was the sensory
impairment,affecting parts of the left arm and
the left foot. Electrophysiological studies
showed conduction blocks in two nerves with
slowed conduction velocity in three motor
and one sensory nerves. In contrast to the few
previously reported cases our patient showed
diffuse symmetrical swelling of the clinically
affected as well as the unaffected plexus
including involvement of the asymptomatic
right side.
Conclusion: MRI is a helpful tool in the
diagnosis of multifocal demyelinating neuropathies
as the LSS. Diffusely swollen brachial
and lumbar plexuses might not only be found
at clinically involved sides but also give a hint
toward so far asymptomatic involvement of
other sides.