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 9 conform strictly to his own description of the clinical characteristics; however there a couple of surprising case clusters of this 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 with patients usually showing a slow start, building up to senasations in many parts of the body[4]. 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[5]