Wartenberg's migratory sensory neuropathy

Wartenberg's Migratory Sensory Neuropathy

(Also known as Wartenberg's Migrant Sensory Neuritis) is a rare condition identified by Robert Wartenberg in 1958 which is easy to confuse with the early stages of multiple sclerosis. However this is a benign relapsing and remitting condition in which pain and subsequent loss of sensation in the distribution of individual cutaneous nerves is induced by movement of the limbs inducing stretch^[1] The movements may be very small, and the periods of pain, dysaesthesia, and numbness can vary from almost instantaneous to chronic. Only a few case studies have ever been reported, and even of Wartenbergs own patients only 2 of the nine conform strictly to his own description of the clinical characteristics, however there a couple of surprising clusters of these condition in both the Thames valley and San Francisco[2]

Cause

Whilst the actual cause of this polyneuropathy remains unknown, most reasearch now puts this as an immune-mediated, chronic, asymmetric polyneuropathy[3]

Symptoms

Positive Tinel's sign is often present. Any cutaneous sensory nerve can be involved. At times, the focal nerve lesions can be painful. Most symptoms resolve but permanent sensory loss can persist. Electrodiagnostic studies demonstrate axon loss in the distribution of the involved cutaneous nerves[4]