Ladislav Gurčík, Peter Špalek, František Cibulčík
We present a case report of a patient with a relapsing progression of asymmetric weakness of the left upper limb muscles without disorders of sensitivity, with the clinical picture of multiplex mononeuropathy. The patient fulfilled cardinal clinical, electromyographic and also supportive diagnostic criteria for the diagnosis of multifocal motor neuropathy (MMN). He was adjusted to chronic maintenance therapy with intravenous immunoglobulin in four-week intervals resulting in clinical improvement. However, after three years of IVIG treatment, mild symptoms of sensory nerve involvement in the lower limbs and the left upper limb occured. The clinical picture and electrophysiological findings currently meet the diagnostic criteria for multifocal acquired demyelinating sensory and motor neuropathy (MADSAM).