Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1972 Feb;35(1):22–30. doi: 10.1136/jnnp.35.1.22

Peripheral neuropathy in chronic liver disease: clinical, electrodiagnostic, and nerve biopsy findings

R P Knill-Jones 1,2,3, C J Goodwill 1,2,3, A D Dayan 1,2,3, Roger Williams 1,2,3
PMCID: PMC493959  PMID: 4337271

Abstract

In a prospective study of 70 unselected patients with chronic liver disease, clinical signs of a peripheral neuropathy were observed in 13 patients. Abnormal nerve conduction was demonstrated in nine of these and in one further patient who had no abnormal neurological signs. The occurrence of a neuropathy (in patients with cryptogenic cirrhosis, haemochromatosis, active chronic hepatitis as well as in alcoholic cirrhosis) could not be related to liver function, although it was associated with higher IgA and IgM values. Clinical diabetes was present in six of the 14 patients with neuropathy but there was no relation in the non-diabetic patients between neuropathy and minor impairment of carbohydrate tolerance. Those with neuropathy had a significantly higher incidence of oesophageal varices and there was also a relationship to a history of previous encephalopathy. Sural nerve biopsy was carried out on 14 patients, eight of whom had clinical or electrodiagnostic evidence of neuropathy. Single nerve fibres were examined by teasing and in all nerves histological evidence was found of an indolent process which had damaged whole Schwann cells and which resulted in demyelination and remyelination. Diabetic angiopathy was not seen and axonal degeneration, which was never severe, was found in all disease groups equally.

Full text

PDF
28

Images in this article

26Image
on p.26
26Image
on p.26
26Image
on p.26
28Image
on p.28

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arnold N., Harriman D. G. The incidence of abnormality in control human peripheral nerves studied by single axon dissection. J Neurol Neurosurg Psychiatry. 1970 Feb;33(1):55–61. doi: 10.1136/jnnp.33.1.55. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Blendis L. M., Laws J. W., Williams R., Thomson W. B. Calcified collateral veins and gross dilatation of the azygos vein in cirrhosis. Br J Radiol. 1968 Dec;41(492):909–912. doi: 10.1259/0007-1285-41-492-909. [DOI] [PubMed] [Google Scholar]
  3. Cavanagh J. B., Kyu M. H. Colchicine-like effect on astrocytes after portacaval shunt in rats. Lancet. 1969 Sep 20;2(7621):620–622. doi: 10.1016/s0140-6736(69)90329-8. [DOI] [PubMed] [Google Scholar]
  4. Dayan A. D., Gardner-Thorpe C., Down P. F., Gleadle R. I. Peripheral neuropathy in uremia. Pathological studies on peripheral nerves from 6 patients. Neurology. 1970 Jul;20(7):649–658. doi: 10.1212/wnl.20.7.649. [DOI] [PubMed] [Google Scholar]
  5. Dayan A. D., Williams R. Demyelinating peripheral neuropathy and liver disease. Lancet. 1967 Jul 15;2(7507):133–134. doi: 10.1016/s0140-6736(67)92967-4. [DOI] [PubMed] [Google Scholar]
  6. Lascelles R. G., Thomas P. K. Changes due to age in internodal length in the sural nerve in man. J Neurol Neurosurg Psychiatry. 1966 Feb;29(1):40–44. doi: 10.1136/jnnp.29.1.40. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Logothetis J., Kennedy W. R., Ellington A., Williams R. C. Cryoglobulinemic neuropathy. Incidence and clinical characteristics. Arch Neurol. 1968 Oct;19(4):389–397. doi: 10.1001/archneur.1968.00480040055005. [DOI] [PubMed] [Google Scholar]
  8. Malkova E. V. Sindrom mnozhestvennogo nevrita pri zabolevaniiakh lecheni. Zh Nevropatol Psikhiatr Im S S Korsakova. 1968;67(8):1189–1193. [PubMed] [Google Scholar]
  9. Mayne N. Neuropathy in the diabetic and non-diabetic populations. Lancet. 1965 Dec 25;2(7426):1313–1316. doi: 10.1016/s0140-6736(65)92339-1. [DOI] [PubMed] [Google Scholar]
  10. Megyesi C., Samols E., Marks V. Glucose tolerance and diabetes in chronic liver disease. Lancet. 1967 Nov 18;2(7525):1051–1056. doi: 10.1016/s0140-6736(67)90334-0. [DOI] [PubMed] [Google Scholar]
  11. Morley J. B., Schwieger A. C. Aspects of chronic polyneuropathy associated with myeloma. Proc Aust Assoc Neurol. 1968;5(2):403–404. [PubMed] [Google Scholar]
  12. Ortiz Vázquez J., Olmo A., Muro J., Villamor J., Barreiro P. Neuropatía hepática. Rev Clin Esp. 1967 Jan 15;104(1):60–66. [PubMed] [Google Scholar]
  13. Seneviratne K. N., Peiris O. A. Peripheral nerve function in chronic liver disease. J Neurol Neurosurg Psychiatry. 1970 Oct;33(5):609–614. doi: 10.1136/jnnp.33.5.609. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Victor M., Adams R. D., Cole M. The acquired (non-Wilsonian) type of chronic hepatocerebral degeneration. Medicine (Baltimore) 1965 Sep;44(5):345–396. doi: 10.1097/00005792-196509000-00001. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES