Hereditary Neuropathy with Liability to Pressure Palsy Presenting as Bilateral Foot Drop.

Abstract

Hereditary neuropathy with liability to pressure palsy (HNPP) is a rare, autosomal dominant disorder that typically presents with episodic, multifocal neuropathy, and recurrent transient pressure palsies. 1 We report a patient who was misdiagnosed as transverse myelitis suggestive of multiple sclerosis based on acute onset bilateral foot drop. However, detailed history, careful examination, and electroneuromyography (ENMG) were consistent with HNPP. A 22-year-old male developed a sudden onset of weakness in his legs. Imaging of the brain and spine, serum, and cerebrospinal fluid analysis were all normal. Normoactive deep tendon reflexes with acute onset were interpreted as transverse myelitis. He was given methylpredniso-lone, which had no obvious effect. He was then referred to our clinic and we learned that the patient had cross-legged sitting while playing a computer game for hours. He had bilateral ankle and toe dorsiflexion weakness; however, inversion was normal bilaterally. He had hypoesthesia