Annals of Indian Academy of Neurology
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Year : 2017  |  Volume : 20  |  Issue : 4  |  Page : 425-429

Clinico-Electrophysiological and genetic overlaps and magnetic resonance imaging findings in Charcot–Marie– Tooth disease: A pilot study from Western India

1 Department of Neurology, Bombay Hospital, Mumbai, Maharashtra, India
2 Department of Neurology, Grant Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India
3 Department of Clinical Electrophysiology, Bombay Hospital, Mumbai, Maharashtra, India
4 Department of Neurology, T.N.M.C and B.Y.L Nair CH. Hospitals, Mumbai, Maharashtra, India

Correspondence Address:
Satish Vasant Khadilkar
Department of Neurology, Bombay Hospital, 110, First Floor, New Wing, 12, New Marine Lines, Mumbai – 400 020, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aian.AIAN_316_17

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Background: Charcot–Marie–Tooth (CMT) disease is clinically and genetically heterogeneous. There are no published series describing clinical, electrophysiological, and genetic information on CMT from the Indian subcontinent. Magnetic resonance imaging (MRI) neurography technique provides useful information about the plexus and roots and can be employed in patients with CMT. Settings and Design: A prospective, observational study carried out at a tertiary care hospital in Western India. Subjects and Methods: CMT patients fulfilling the UK Genetic Testing Network criteria were included. They underwent clinical, electrophysiological, radiological, and multigene panel testing. Results: Totally 22 patients (19 males, 3 females; 18 sporadic and 4 familial cases) were studied. Pes cavus (19), hammer toes (16), and scoliosis was seen in 1 patient. Electrophysiology revealed motor predominant neuropathy with 15 demyelinating (10 uniform and 5 multifocal) and 7 axonal patterns. Thickened lumbosacral plexuses on MRI neurography were evident in 6/10 studied patients, all 6 having demyelinating neuropathy. Genetic analysis identified PMP22, GJB1, SH3TC2, HSPB1, SPTLC2, MPZ, AARS, and NEFH gene mutations. Conclusions: This small series documents the pattern of CMT neuropathies as seen in Western India. Clinico-electrophysiological and genetic diagnosis showed general concordance some overlaps and reiterated advantages of gene panel testing in this heterogeneous group of neuropathies. MRI neurography was useful as an additional investigation to detect nerve enlargement in patients with demyelinating neuropathies.

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