Polyneuropathy associated with neurofibromatosis

INTRODUCTION: We review the literature on the spectrum of polyneuropathies associated with neurofibromatosis 1 (NF1) and 2 (NF2). BACKGROUND: Symptomatic neuropathies in NF1 are rarer than in NF2, but constitute a potentially severe complication associated with frequent morbidity related to the neuropathy itself, spinal cord compression or peripheral nerve sheath tumor malignant degeneration. Neuropathies are typically observed in young men with subcutaneous neurofibromas (NF1) or cutaneous schwannomas (NF2) and are characterized by a chronic slowly worsening sensorimotor polyneuropathy of the lower limbs. In NF1, demyelinating neuropathy may occur alone or in association with axonal features, whereas in NF2, axonal neuropathies are reported. Large multinodular roots and nerves, which can be easily detected by limb MRI, are characteristic features of NF1-associated polyneuropathies. PERSPECTIVES AND CONCLUSION: Although an associated pathogenic factor may reveal an asymptomatic neuropathy, patients should be monitored carefully because of the increased morbidity and mortality related to the significant proportion of malignant nerve-sheath tumors in these patients with NF1.