Gabriel Hajaš1, Branislav Veselý1, Miroslav Brozman1, Peter Reško2, Helena Poláková3, Ľudevít Kádaši3
Hereditary neuropathy with liability to pressure palsies (HNPP), the mildest form of CMT disease, is manifested by episodic, recurrent peripheral nerve palsy, which is often preceded by history of minor trauma at vulnerable sites. In the first report we describe a case of man with history of several injuries. The patient was initially presented to the Clinic of Neurology for upper limb weakness and atrophy of interosseal muscles. Clinical and EMG findings indicated for bilateral lesion of ulnar nerves with partial conduction block in the elbow region. The condition was considered as the bilateral ulnar nerv entrapment at the elbow. Neurosurgery of ulnar nerve didn´t provide excepted benefit. Due to a development of weakness and atrophy of the legs, we consecutive supposed hereditary neuropathy. DNA analysis confirmed deletion in 17p11.2 region, that contains the gene for peripheral myelin protein 22 (PMP 22). HNPP was thus established. In the second case we describe the daughter of the above named patient, who presented with a bilateral carpal tunnel syndrome. Given the clinical and EMG findings we assumed HNPP, the result of the DNA analysis still is not available. We can avoid unnecessary surgery at the entrapment regions by the early and correct diagnosis of HNPP. The patients can thus be informed about their diagnosis, prognosis ant type of inheritance.