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Clinical and Morphologic Study

Otto Appenzeller, MD, PhD; Mario Kornfeld, MD

Arch Neurol. 1973;29(5):334-339.

Abstract
A man with acute pandysautonomia was examined clinically on two occasions four years apart. Complete autonomic paralysis was demonstrated at first examination, with almost complete recovery subse quently. A sural nerve biopsy 12 years after onset of the disorder showed a striking increase in the number of miniature unmyelinated axons consistent with regeneration. Myelinated fibers showed some morphologic features suggestive of remyelination; these were not prominent and no degeneration of myelinated axons was found. Morphologic features and results of autonomic function tests were consistent with a primary, if not exclusive, involvement of unmyelinated postganglionic fibers. Pathogenesis of this disorder is unclear but clinical features and natural history are most compatible with an immunologic basis.

Author Affiliations
Albuquerque, NM

From the departments of neurology (Dr. Appenzeller) and pathology (Dr. Kornfeld), University of New Mexico School of Medicine, Albuquerque.

Footnotes
Accepted for publication June 13, 1973.

Reprint requests to Department of Neurology, University of New Mexico School of Medicine, Albuquerque, NM 87131 (Dr. Appenzeller).

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