Annals of Indian Academy of Neurology
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AIAN REVIEW
Year : 2022  |  Volume : 25  |  Issue : 6  |  Page : 1001-1008

Nodo-paranodopathies: Concepts, clinical implications, and management


Departments of Neurology, Bombay Hospital Institute of Medical Sciences, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Satish V Khadilkar
Deanfs Office, First Floor, Bombay Hospital, 12, New Marine Lines, Mumbai - 400 020, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aian.aian_382_22

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Peripheral neuropathies are traditionally categorized into demyelinating or axonal. It has been proposed that dysfunction at nodal/paranodal region may be a key for better understanding of pathophysiology in patients with immune mediated neuropathies. In last few years, antibodies targeting node and paranode of myelinated nerves have been increasingly detected in patients with immune mediated neuropathies. These patients have clinical phenotype similar common inflammatory neuropathies like Guillain Barre syndrome and chronic inflammatory demyelinating polyradiculoneuropathy with some additional atypical neurological and systemic features, and they respond poorly to conventional first line immunotherapies like IVIG. This review summarizes the structure of the node, concept and pathophysiology of nodopathies. We provide an overview of clinical phenotypes in patients with specific nodal/paranodal antibodies, along with electrophysiological and other diagnostic features and suggest therapeutic line of management based on current evidence.


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