Title: Recurrent polyneuropathy with pregnancy and oral contraceptives.

POPLINE Document Number: 702135

Author(s):

Calderon-Gonzalez R
Gonzalez-Cantu N
Rizzi-Hernandez H

Source citation:

New England Journal of Medicine, June 4, 1970;282(23):1307-1308.

Abstract:

This is a case report of a 26-year-old patient with recurrent symmetrical polyneuropathy with 3 consecutive pregnancies and while taking oral contraceptives. She was admitted to the hospital complaining of numbness of hands and feet and progressive weakness of all limbs. Similar symptoms had occurred during 3 previous pregnancies and had progressed to quadraplegia with areflexia. The pregnancies ended in normal deliveries. In the first pregnancy symptoms disappeared in 2 months; in the subsequent ones symptoms appeared earlier and required 6 months to disappear. After the third pregnancy she received for 9 months a chlormadinone acetate and mestranol contraceptive, then ethynodrel diacetate and mestranol. 2 months later symptoms began and progressed in 1 month to complete quadriplegia. She stopped the contraceptive as soon as symptoms began. There was no pregnancy, no cranial nerve involvement, nor muscle atrophy. Distal hypalgesia and decreased position and vibration senses were noted. Nerve conduction velocity was diminished. Muscle biopsy was normal. Nerve biopsy showed degeneration of the myelin sheath with relative preservation of axons. Laboratory tests were normal except for elevated spinal fluid protein. Recovery was slower than previously. After 2 years slight foot-drop was present. There seemed to be a relation between female hormones and the recurrent disorder. The possibility that immunopathologic factors were involved was considered.

Keywords:

Case Studies
Central Nervous System Effects
Pregnancy Complications
Chlormadinone Acetate
Mestranol
Ethynodiol Diacetate
Immunological Effects
Side Effects
Oral Contraceptives, Combined
Contraceptive Agents, Side Effects
Women
Studies
Research Methodology
Central Nervous System
Physiology
Biology
Diseases
Contraceptive Agents, Progestin
Contraceptive Agents, Female
Contraceptive Agents
Contraception
Family Planning
Contraceptive Agents, Estrogen
Immunity
Immune System
Treatment
Oral Contraceptives
Contraceptive Methods
Demographic Factors
Population