{"id":8652,"date":"2021-06-18T16:11:49","date_gmt":"2021-06-18T16:11:49","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=8652"},"modified":"2026-01-05T18:51:29","modified_gmt":"2026-01-05T18:51:29","slug":"ganglionopathies","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/ganglionopathies\/","title":{"rendered":"Investigations to Evaluate Sensory Ganglionopathies"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Among disorders that cause sensory loss, the most distinctive are those that affect the sensory ganglia. These disorders are called sensory neuronopathies or sensory ganglionopathies. The importance of sensory ganglia, in addition to the unique topography of sensory loss that occurs when they are diseased, lies in their close association with general medical disorders, and paraneoplastic disorders in particular. Furthermore, ganglia may be susceptible to autoimmune attack because of the fenestrated endothelial cells that form a permeable blood\u2013nerve barrier. <!--more--><\/p>\n<p><strong>Investigations to Evaluate Sensory Ganglionopathies<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"width: 23.6264%;\">Variable<\/td>\n<td style=\"width: 76.3736%;\">Evaluation<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 23.6264%;\">Assessment in all cases<\/td>\n<td style=\"width: 76.3736%;\">Sensory- and motor-nerve conduction studies to look for demyelinating or axonal physiology (results should be axonal and purely sensory in large-fiber sensory ganglionopathy but may be normal in small-fiber sensory ganglionopathy)<br \/>\nConsider cerebrospinal fluid testing<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 100%;\" colspan=\"2\">Assessment according to specific cause<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 23.6264%;\">Paraneoplastic syndrome<\/td>\n<td style=\"width: 76.3736%;\">Testing for anti-Hu, anti-CRMP5, and anti-amphiphysin antibodies\u00a0SPEP or IFE assays for monoclonal gammopathy, which can be seen\u00a0with lymphomas and plasmacytomas<br \/>\nWhole-body PET-CT to look for cancer, followed by diagnostic biopsy<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 23.6264%;\">Sj\u00f6gren\u2019s syndrome<\/td>\n<td style=\"width: 76.3736%;\">Testing for ANA, anti-Ro, and anti-La antibodies<br \/>\nTesting with Schirmer\u2019s test or rose\u2013bengal staining for keratoconjunctivitis sicca<br \/>\nMinor salivary gland biopsy<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 23.6264%;\">Celiac disease<\/td>\n<td style=\"width: 76.3736%;\">Consider testing for antigliadin and antitransglutaminase autoantibodies<br \/>\nEndoscopy and tissue biopsy\u2020<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 23.6264%;\">Infection<\/td>\n<td style=\"width: 76.3736%;\">HIV serologic testing (also consider testing for HTLV-1, EBV, VZV,\u00a0Zika virus, leprosy)<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 23.6264%;\">Vitamin toxicity<\/td>\n<td style=\"width: 76.3736%;\">Measurement of vitamin B6 (pyridoxine) level<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 23.6264%;\">Assessment of idiopathic large- and small-fiber\u00a0sensory ganglionopathies<\/td>\n<td style=\"width: 76.3736%;\">Consider testing for anti\u2013trisulfated heparin disaccharide and\u00a0anti\u2013fibroblast growth factor receptor 3 antibodies\u2021<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 23.6264%;\">Assessment of idiopathic small-fiber sensory\u00a0ganglionopathies<\/td>\n<td style=\"width: 76.3736%;\">Consider skin biopsies of distal leg and thigh to measure intraepidermal nerve-fiber density<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>*ANA denotes antinuclear antibodies, CRMP5 collapsin response mediator protein 5, IFE immunofixation electrophoresis, PET-CT positron-emission tomography\u2013computed tomography, and SPEP serum protein electrophoresis.<br \/>\n\u2020 Antigliadin and antitransglutaminase autoantibodies are not specific for celiac disease or the associated subtype of<br \/>\nperipheral neuropathy. They may be seen in axonal sensory and sensorimotor ganglionopathies.<br \/>\n\u2021 Anti\u2013trisulfated heparin disaccharide and anti\u2013fibroblast growth factor 3 receptor antibodies are not specific for the subtype of peripheral neuropathy. They may be seen in axonal sensory and sensorimotor ganglionopathies, and their presence does not indicate an immunologic cause of the neuropathy.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Amato AA, Ropper AH. Sensory Ganglionopathy. N Engl J Med. 2020 Oct 22;383(17):1657-1662. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33085862\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Gwathmey KG. Sensory neuronopathies. Muscle Nerve. 2016 Jan;53(1):8-19. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26467754\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Jun 17, 2021.<\/p>\n<p>&nbsp;<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[2],"tags":[1568,2226,2384,2386,2385,2383,2387,1850],"class_list":["post-8652","post","type-post","status-publish","format-standard","hentry","category-neurology","tag-evaluar","tag-evaluate","tag-ganglionopathies","tag-ganglionopatias","tag-investigaciones","tag-investigations","tag-sensoriales","tag-sensory"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/8652","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=8652"}],"version-history":[{"count":6,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/8652\/revisions"}],"predecessor-version":[{"id":8659,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/8652\/revisions\/8659"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=8652"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=8652"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=8652"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}