Cmt?

[kapMD/PhD]

Clinical question for you:
50+ YO white female
distal symmetrical neuropathy of the legs from approximately 2-3 inches above the knees down to the feet. good muscle mass and function. possibily Charcot Marie Tooth, which runs in the family. Because of age of onset of symptoms and the pathologic descriptors of symptoms, CMT 2 subclass, if CMT is definitive. EMG confirmed the neuropathy.

Is a CT myelogram indicated to determine if lumbar nerve compression is the cause of the neuropathy? I suggested a genetic test for CMT considering family history and symptoms. ALso in the literature that I have read, lumbar nerve compression is not on the differential for CMT; also it seems that bilateral lumbar compression is really rare. Any thoughts are appreciated.

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[neurologist]

Back pain?
Injury?
Pretty unusual for lumbar probs to give "distal symmetric neuropathy."

CT myelogram?!?!?!? Hows about an MRI if you feel compelled to image . . .

 

[kapMD/PhD]

no recent injury, no hip surgery, no pelvic in general surgery, no recent births, no history of fractures, no back pain.

 

[buckley]

i may not just be familiar with your lingo or jargon, but what exactly is going on in the distal legs? What sensory systems are lost or are they all gone? Does it reflect specific dermatomal patterns that you're main localization is in the spine? Or could it perhaps be more peripheral? It could just be diabetes you know, 50 year old female? Or get those serum b12 levels and a VDRL screen.