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Patrice H. Lalive, MD; André Truffert, MD; Michel R. Magistris, MD; Théodor Landis, MD; André Dosso, MD

Arch Neurol. 2009;66(3):403-405.

Background  Corneal nerves can be examined using in vivo confocal microscopy (IVCM). This new technique permits sequential observation of the corneal subbasal nerve plexus and detects early signs of diabetic peripheral neuropathy.

Objective  To describe a patient with autoimmune peripheral neuropathy followed up using corneal IVCM.

Design  Case report.

Setting  Clinic of neurology, Geneva, Switzerland.

Patient  A 56-year-old man with peripheral neuropathy diagnosed as anti–myelin-associated glycoprotein neuropathy. His symptoms initially worsened despite the administration of intravenous immunoglobulins and plasma exchange. Evolution was eventually favorable after rituximab and corticosteroids were given. At 1-year follow-up, clinical recovery was almost complete, and the patient was stable according to the results of clinical and electrophysiologic assessments.

Main Outcome Measure  Corneal nerve measurement by IVCM.

Results  Examination of corneal nerves using IVCM at 2 different times during the patient's clinical evolution (peak disease and recovery phase) demonstrated histologic signs that correlated with the results of clinical and electrophysiologic assessments.

Conclusion  This observation supports the hypothesis that corneal IVCM could also be helpful for the early detection or follow-up of autoimmune peripheral neuropathy.

Author Affiliations: Divisions of Neurology (Drs Lalive, Truffert, Magistris, and Landis) and Ophthalmology (Dr Dosso), Department of Clinical Neurosciences, Geneva University Hospital, Faculty of Medicine, Geneva, Switzerland.

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RELATED LETTERS

In Vivo Confocal Microscopy of Corneal Stromal Nerves in Patients With Peripheral Neuropathy
Dipika V. Patel and Charles N. J. McGhee
Arch Neurol. 2009;66(9):1179-1180.
EXTRACT | FULL TEXT  

In Vivo Confocal Microscopy of Corneal Stromal Nerves in Patients With Peripheral Neuropathy—Reply
Patrice H. Lalive and André Dosso
Arch Neurol. 2009;66(9):1180.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

In Vivo Confocal Microscopy of Corneal Stromal Nerves in Patients With Peripheral Neuropathy
Patel and McGhee
Arch Neurol 2009;66:1179-1180.
FULL TEXT