Search Results (1,007)

Background: Traumatic brain injury (TBI) damages brain tissues and affects the ocular system. Ocular manifestations such as orbital fractures, ocular surface disease, photosensitivity, impaired pupillary response, and retinal damage often co-occur with TBI. Despite established diagnostic criteria, a gap remains, particularly in detection, monitoring, and recovery prediction. Since ocular manifestations co-occur with TBI, they may offer non-invasive means to address this gap. Accordingly, this review evaluates whether TBI-associated ocular manifestations can serve as biomarkers for TBI detection, monitoring, and recovery. Methods: A literature search was conducted across three databases for studies that address ocular manifestations of TBI listed above. Results: Orbital fractures occur in 69%, matching TBI severity. Occult fractures may indicate unseen mild TBI on advanced neuroimaging. Dry eye disease prevalence is inconsistent (15 and 37%). Tear film proteomics show altered inflammatory and repair proteins, though this area remains understudied. Vitreous total tau and neurofilament light chain correlate with brain levels in chronic traumatic encephalopathy. Photosensitivity affects approximately 50% of acute TBI and declines to 14% after three months. NPi-200 pupillometer shows high specificity in triaging acute injury but with low sensitivity. PLR-3000 pupillometer and smartphone applications require further validation. Retinal imaging shows biphasic thickening then progressive thinning, modulated by sex, severity and duration. Conclusions: No single ocular biomarker fulfills all roles. Instead, different markers map into distinct stages of the clinical course. Future research should prioritize molecular markers in the tear film, combined with changes in corneal nerves across different TBI severities. Full article

Background/Objectives: Iatrogenic brachial plexus injuries (BPI) are known to occur following a host of surgeries, most often during procedures at the shoulder and cardiac procedures with a median sternotomy. The primary mechanisms include overstretching of the brachial plexus, direct trauma, or compression by hematoma or seroma. Our objective was to determine the pattern of iatrogenic BPI in patients referred to us for electrodiagnostic (EDX) evaluation. Methods: This is a review of 52 patients who were referred to our Neurodiagnostic Center for an iatrogenic BPI over a 16-year (9 July 2010–17 June 2026) period. All patients underwent a clinical examination and EDX studies. Results: The most frequent etiologies of the iatrogenic BPI were shoulder surgery in 28 [53.8%] patients and coronary artery bypass graft procedures with a median sternotomy in 13 [25.0%] patients. The topography of brachial plexus involvement was trunks in 22 (42.3%) and cords in 12 (23.1%). Ten (19.2%) patients had a pan-plexopathy, and the remaining eight (15.4%) patients had multiple sites involving the trunks, cords, and branches. The majority (48 [92.3%]) of patients sustained a stretch injury of the brachial plexus, and four (7.7%) sustained a direct injury. A total of 48 (92.3%) patients had reduced motor unit potential recruitment and/or increased polyphasic motor units on needle EMG, and a similar number had an absence of or low amplitude sensory nerve action potentials. Conclusions: Surgeons should take appropriate precautions to avoid BPI during many surgical procedures especially those of the shoulder and cardiac procedures with a median sternotomy. EDX studies are valuable in detecting and localizing an iatrogenic BPI as well as assessing reinnervation. Preoperative positioning limiting excessive shoulder abduction as well as intraoperative neuromonitoring are measures that may reduce the likelihood of an iatrogenic BPI. Full article

Vagal afferent stimulation exerts potent anti-inflammatory effects through neuroimmune pathways involving the sympathetic nervous system and spleen. However, how vagal afferent stimulation affects splenic responses and CellTrace-positive signals in inflamed tissues remains unclear. In this study, we investigated the effects of vagal afferent electrical stimulation (aVNS) on splenic responses and acute lung inflammation induced by intratracheal lipopolysaccharide (LPS) in mice. As a preconditioning intervention, aVNS was applied to the right cervical vagus nerve 24 h before LPS administration. Pulmonary inflammation was evaluated by measuring tumor necrosis factor-α (TNF-α) levels in bronchoalveolar lavage fluid. Splenic responses were assessed by measuring spleen weight, and CellTrace-positive signals were evaluated following direct intrasplenic injection of CellTrace™ Far Red. aVNS significantly reduced BALF TNF-α levels (sham: 5443 ± 404 pg/mL, n = 5; aVNS: 2891 ± 756 pg/mL, n = 5) following LPS administration. In addition, aVNS reduced spleen weight 24 h after stimulation. Furthermore, the ratio of CellTrace Far Red-positive cells was significantly higher in the aVNS + LPS group than in the sham + LPS group (0.00504 ± 0.00056 vs. 0.00151 ± 0.00017, n = 4 per group). These findings indicate that vagal afferent stimulation reduces the BALF TNF-α response to LPS and is associated with reduced spleen weight and increased CellTrace-positive objects detected in lung sections. These observations suggest that changes in splenic and immune-cell dynamics may accompany the anti-inflammatory effects of vagal afferent stimulation. Full article

Background and Objectives: Pseudoexfoliative glaucoma (PEXG) is a secondary glaucoma caused by the deposition of abnormal flaky protein-like material inside the eye, leading to blockage of the drainage system, increased intraocular pressure (IOP), and optic nerve damage. This study aimed to evaluate the effects of latanoprost and timolol–dorzolamide therapy on the concentrations of interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12p70, and tumor necrosis factor-alpha (TNF-α) in the aqueous humor and serum samples of patients with PEXG. Materials and Methods: This prospective observational study included 60 patients allocated to three age-matched groups (n = 20 per group). Group 1 received latanoprost therapy, Group 2 received timolol–dorzolamide therapy, and Group 3 comprised patients with cataracts without PEXG who were not receiving antiglaucoma medication (control group). All participants underwent a comprehensive ophthalmological examination, including visual acuity assessment, specular microscopy, IOP measurement, and intraocular lens (IOL) measurement. Peripheral venous blood was taken from each patient before the surgical procedure and aqueous humor samples were collected during cataract surgery. Concentrations of IL-1β, IL-6, IL-8, IL-10, IL-12p70, and TNF-α were determined using a Cytometric Bead Array and flow cytometry. Results: No significant differences were observed in the aqueous humor and serum concentrations of IL-6 and IL-8 between the treatment groups, while IL-1β, IL-10, IL-12p70, and TNF-α did not reach detection. A significant positive correlation was found between IOL and aqueous humor IL-6 concentration in group 1 and between IL-6 and IL-8 serum concentration and IOP in controls. Conclusions: Latanoprost and timolol–dorzolamide therapy were not associated with significant differences in aqueous humor or serum IL-6 and IL-8 concentrations in patients with PEXG. IL-1β, IL-10, IL-12p70, and TNF-α were not detectable in the analyzed samples. These findings support the presence of low-grade inflammation in patients with PEXG that does not differ according to the therapy administered. Corneal endothelial alterations are disease-related rather than treatment-induced. Full article

Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and dose-limiting toxicity in child, adolescent, and young adult (CAYA) oncology populations. Despite its clinical impact, objective biomarkers for early detection and monitoring remain limited. Neurofilament light chain (NfL), a marker of axonal injury, has emerged as a potential circulating biomarker of CIPN in adults and potentially for CAYAs. This pilot study evaluates the association between NfL and patient-reported CIPN severity in CAYAs. Methods: We conducted a prospective pilot study of 26 patients with acute lymphoblastic leukemia or lymphoma. CIPN was assessed using FACT-GOG/NTx scores. Linear mixed-effects models evaluated associations between NfL and neuropathy over time, adjusting for age and time from baseline. Logistic mixed models assessed the relationship between NfL and clinically significant neuropathy (FACT-GOG/NTx ≤ 40). Results: NfL was significantly associated with worsening neuropathy. A 50-unit increase in NfL corresponded to a 1.1-point decrease in FACT-GOG/NTx score (p < 0.001). Each doubling of NfL was associated with a 0.61-point decrease in FACT-GOG/NTx (p < 0.001). Higher NfL levels increased odds of neuropathy (OR 4.62, p < 0.001). Associations were strongest in leukemia patients and not observed in Hodgkin lymphoma when separately analyzed. Conclusions: This pilot study demonstrates that circulating NfL correlates with patient-reported neuropathy severity, supporting its role as a potential biomarker for CIPN in CAYAs. Differences between leukemia and lymphoma cohorts may reflect treatment-specific neurotoxicity patterns and should be validated in larger prospective studies. Limitations include small sample size, heterogeneity, and limited power for subgroup analyses. If validated, NfL could be incorporated into routine toxicity monitoring to identify patients at highest risk for progressive CIPN, enabling earlier supportive care interventions, referral to rehabilitation services, or enrollment in biomarker-guided prevention and treatment trials before irreversible nerve injury occurs. Full article

Background and Objectives: The hybrid assistive limb (HAL) is a wearable robotic device used for rehabilitation that assists the voluntary movements of the user by detecting muscle action potentials and driving actuators positioned next to the hip and knee joints. Although upper-limb HAL training has been studied for brachial plexus injury (BPI), its electrophysiological influence remains unclear. The purpose of this study was to assess the electrophysiological influences of upper-limb HAL-assisted biofeedback (BF) training during elbow flexion rehabilitation in patients with BPI. Methods: Five patients with BPI (average age, 37.2 years) were enrolled after undergoing elbow flexor reconstruction through intercostal nerve-to-musculocutaneous nerve transfer. All participants received outpatient elbow flexion training with the upper-limb HAL at frequencies ranging from once weekly to once monthly. All patients started upper-limb HAL training when re-innervation was observed, and a biceps brachii muscle strength of grade 1 was achieved. Muscle activity was measured using surface electromyography in five patients during upper-limb HAL training, when the biceps brachii muscle strength was graded as Medical Research Council grades 1 and 2, to compare activity with and without HAL. Results: In five patients, electromyographic activity of the biceps brachii during elbow flexion reached 74.9 ± 22.7% of maximal contraction while using the HAL device, compared with 60.3 ± 16.7% without HAL assistance, indicating significantly greater muscle activation during HAL-assisted movement. Conclusions: Robotic BF training for elbow flexion with the upper-limb HAL may serve as a high-quality electromyographic rehabilitation approach for patients recovering from BPI. Full article

Single-cell RNA sequencing is a state-of-the-art approach to decipher the heterogeneity of RNA transcripts in individual cells and identify different cell types in tissues and organs. Its aim is to create a high-resolution cell atlas to better understand organs and diseases. In this narrative review, we focus on the main endometrial cell types and their possible significance in endometriosis. Examination of the normal endometrium (NEM), eutopic endometrium of patients (EUE) and ectopic endometrium (EMS) revealed a predominance of endometrial stromal cells (ESCs), followed by epithelial cells (EECs), immune cells (ICs), endothelial cells (ECs) and pericytes (PVs). Comparison of the NEM with the EUE showed only minor changes in ESC and EEC proportions, but a dramatic increase in ICs in EUE, especially uterine macrophages (uM1). The ESC-IC homeostasis was especially disturbed. In EMS a marked reduction in EEC and NK cell proportions was found, accompanied by a significant increase in ECs and M2 macrophages. Furthermore, in EMS a significant shift from fibroblasts (Fibs) to myofibroblasts (MyoFibs), indicating fibrosis, was reported. Of note, ESC/EEC stem cells were described only very rarely, while nerve cells were not detected. In summary, scRNA-seq provided a good description of the cell proportions in NEM and EUE, but further studies are needed to analyze EMS. In conclusion, strong evidence supports the critical importance of ICs and immune system dysregulation in initiation and of ECs and MyoFibs in angiogenesis and fibrosis, respectively, in the pathogenesis of endometriosis. Full article

Diffusion-weighted imaging (DWI) has evolved from a niche research sequence into an increasingly valuable adjunct to conventional magnetic resonance imaging (MRI) in musculoskeletal (MSK) radiology. By providing qualitative and quantitative information on tissue microstructure through assessment of water diffusion and apparent diffusion coefficient (ADC) mapping, DWI offers functional insights beyond conventional morphological imaging. We aim to present the current evidence for DWI in MSK imaging organised around established applications and emerging applications, with particular emphasis on composition-related interpretive pitfalls relevant to differentiating tumours and other pathologies, and to review the technique’s evolving role in routine practice. This narrative review synthesises the current literature on the clinical utility of DWI in MSK imaging. It is structured in four parts: foundations and the tissue composition signal framework, including the basis of qualitative and quantitative assessment; established applications; emerging applications; and assessment of tissue composition-related interpretive as well as technical pitfalls, including those arising due to myxoid matrix, chondroid matrix, blood degradation products, organising thrombus, crystalline or mineralised material, keratinaceous debris, purulent content, cellular haematopoietic marrow, by using original cases from the authors’ institution, which have been confirmed either histologically or surgically. Applications are stratified by strength of evidence. Established applications of DWI include soft tissue abscess detection, differentiation of malignant from benign soft tissue tumours, differentiation of malignant from benign vertebral compression fractures, and myeloma staging and response assessment, as well as treatment response in soft tissue and bone sarcomas. Whole-body MRI with DWI for staging and response assessment in multiple myeloma is guideline-endorsed and supported by prospective multicentre data. Soft tissue abscess detection, soft tissue and bone tumour characterisation, and characterisation of vertebral compression fractures are supported by consistent evidence from multiple independent cohorts, although no universally transferable ADC threshold exists. The emerging applications, which are promising adjuncts supported by small, single-centre or heterogeneous studies with thresholds that have not been externally validated, include ADC ghost sign in osteomyelitis (high specificity but sensitivity of only 20%), peripheral nerve sheath tumour characterisation and surveillance in NF1 patients, peripheral neuropathy and plexopathy, predisposing conditions such as Li Fraumeni syndrome in paediatric cancers, inflammatory myopathy, and postsurgical assessment of residual disease, as well as opportunistic detection of venous thrombosis. Radiomics and machine learning approaches remain experimental. Recent technical advances, including reduced field-of-view imaging, multi-shot acquisition and improved fat suppression, have mitigated but not eliminated historical limitations of susceptibility artefacts and limited spatial resolution. DWI has become an important functional imaging technique that complements conventional MRI across a broad range of musculoskeletal disorders. Understanding the relationship between tissue composition and the diffusion signal is central to both interpreting DWI correctly and avoiding its characteristic pitfalls. DWI is best regarded not as a stand-alone technique but as one component of a multiparametric assessment, in which its functional information is integrated with conventional morphological imaging. Ongoing technical improvement and expanding clinical evidence are expected to further support its integration into routine MSK imaging and its development as a quantitative biomarker for diagnosis, prognostication, and treatment monitoring. Full article

Background/Objectives: Ulnar nerve neuropathy at the elbow (UNE) is the second most common focal neuropathy of the upper extremity and often results from entrapment of the ulnar nerve as it traverses the elbow with insidious onset and gradual progression. This study describes the clinical, electrodiagnostic (EDX), and ultrasound (US) findings in a cohort of patients presenting with acute UNE. Methods: This is a review of 103 patients with clinical features of UNE with acute onset who underwent EDX and US studies over a 25-year period (2010–2026) at our Neurodiagnostic Center. Results: Of the 103 patients with acute UNE, all experienced paresthesia in the ulnar nerve distribution. A total of 27 (26.2%) patients had elbow pain, and 99 (96.1%) had decreased pinprick sensation in the ulnar nerve distribution. Weakness of the following muscles was detected: abductor digiti minimi (ADM) (94 [91.3%]), FDI (first dorsal interosseous) (91 [88.3%]), and FDPu (flexor digitorum profundus—ulnar) (76 [73.8%]). Most patients had a clinical grade of 3 (severe: sensory and motor abnormalities as well as atrophy of the FDI and ADM muscles) (93 [90.3%]). Perioperative injuries were the most common etiology of acute UNE, consisting of 65 (63.1%) patients. The perioperative injury was noted after surgical procedures at varied locations, most frequently at the shoulder in 23 (35.4%) followed by coronary artery bypass in 9 (13.8%) and knee joint surgery in 8 (12.3%). Non-iatrogenic injuries affected 11 (10.7%) patients. The US study revealed cysts and tumors such as a Schwannoma in 14/76 (18.4%) patients. Focal demyelination was observed by EDX studies in 95 (92.2%) patients, and a conduction block was detected in 24 (23.3%). Motor and sensory axonal involvement was identified in 81 (78.6%) and 86 (83.5%) patients, respectively. Of the 76 patients who underwent an US study, 68 (90.6%) had an increase in the cross-sectional area of the ulnar nerve and 51 (68.0%) had a hypoechoic ulnar nerve at the elbow. Conclusions: In this study, the most common cause of acute UNE was periprocedural injury, most frequently following shoulder surgery. Acute UNE may also occur without a history of antecedent trauma or a surgical procedure. EDX and US studies provide complementary data to determine the severity and the etiology of acute UNE and guide further management. Full article

Background/Objectives: Regional anesthesia techniques are increasingly being incorporated into multimodal analgesia for septorhinoplasty. This study compared the postoperative analgesic efficacy and recovery profiles of infraorbital–infratrochlear (ION–ITN) nerve block and transnasal sphenopalatine ganglion (SPG) block techniques. Methods: In this prospective, randomized, double-blind trial, 93 patients undergoing septorhinoplasty received bilateral ION–ITN block (n = 45) or transnasal SPG block (n = 48). The primary outcome was postoperative pain assessed using the Numerical Rating Scale (NRS). Peak postoperative NRS scores at the predefined assessment intervals were evaluated with a linear mixed-effects model adjusted for relevant covariates. Continuous variables are presented as medians (first quartile–third quartile [Q1–Q3]), and categorical variables as numbers (percentages). Secondary outcomes included emergence agitation (Riker Sedation–Agitation Scale (RSAS)), rescue tramadol use, patient satisfaction, and adverse events. Results: Pain scores decreased significantly over time in both groups (p < 0.001). No significant group effect was observed (p = 0.726), and adjusted between-group differences were not significant at any postoperative interval (all p > 0.05). Although the group-by-time interaction showed a trend toward statistical significance (p = 0.053), no meaningful differences in postoperative pain trajectories were observed between the two groups. Median RSAS scores were lower in the SPG group (3 [2,3,4] vs. 4 [3,4], p = 0.04), whereas emergence agitation incidence, tramadol use, patient satisfaction, and adverse events were similar. Conclusions: Within the multimodal analgesic regimen, no statistically significant differences in postoperative pain outcomes were detected between ION–ITN and transnasal SPG block. Because this study was not designed as an equivalence or non-inferiority trial, these findings should be interpreted as an absence of detected differences rather than proof of equivalent analgesic efficacy. Although SPG block was associated with lower agitation scores, this finding suggests reduced agitation severity rather than superior overall analgesic efficacy. Full article

Background: Neurodynamic techniques are commonly used to improve neural mobility and musculoskeletal function, but their effects on muscle mechanical properties remain unclear. This study investigated the acute effects of femoral nerve slider, femoral nerve tensioner, and static stretching interventions on the rectus femoris and vastus medialis muscles. Methods: Thirty healthy adults (18–35 years) were non-randomly allocated using a predetermined alternating sequence to a femoral nerve slider (n = 10), femoral nerve tensioner (n = 10), or static stretching group (n = 10). No sham or no-intervention control group was included. Muscle mechanical properties were assessed before and immediately after the intervention using the MyotonPRO (Myoton AS, Tallinn, Estonia). Outcomes included muscle tone, stiffness, logarithmic decrement, relaxation time, and creep. A three-way mixed repeated-measures ANOVA was performed. Results: No statistically significant differences in pre–post changes were detected among the three intervention groups for any of the examined mechanical parameters. Significant main effects of time were found for stiffness (p = 0.026) and creep (p = 0.005), indicating overall reductions from pre- to post-assessment. Significant time × muscle interactions were identified for relaxation time (p = 0.029) and creep (p = 0.002), indicating different temporal patterns between the rectus femoris and vastus medialis. Following Holm adjustment of the follow-up comparisons, the pre–post reduction in the vastus medialis remained statistically significant for creep but not for relaxation time. The rectus femoris demonstrated greater stiffness and logarithmic decrement values, whereas the vastus medialis exhibited greater relaxation time values. Conclusions: No statistically significant differences in immediate pre–post changes in quadriceps muscle mechanical properties were detected among the femoral nerve slider, femoral nerve tensioner, and static stretching groups. Temporal and muscle-specific patterns were observed for selected mechanical parameters; however, these findings should not be interpreted as evidence of equivalence between the interventions. Full article

Background/Objectives: Inclusion body myositis (IBM) causes progressive, quadriceps-predominant weakness that impairs mobility and increases fall risk, yet outcomes most relevant to independence remain unsynthesized for IBM. This review compiles direct IBM evidence across five domains (A1–A5): natural history, motor performance, falls and balance, sensory/peripheral-nerve function, and interventions. Methods: Eight databases and two trial registers were searched without date or language limits. Eligible studies enrolled adults with IBM based on recognized criteria reporting lower-limb strength or function, gait, transitional tasks, balance, falls, or intervention outcomes; mixed-myopathy cohorts required extractable IBM-specific data. Two reviewers independently screened, extracted, and appraised risk of bias, following PRISMA 2020. Results: Sixty-four studies were included; per-domain totals (A1: 16, A2: 9, A3: 6, A4: 2, and A5: 38) exceed 64 because studies may span domains. Quadriceps strength was the most sensitive progression marker, detected earlier by quantitative testing. Falls were near-universal and insufficiently managed. No drug showed convincing functional benefit in controlled trials, whereas exercise and orthotic/robotic assistance appeared to be safe in small studies. Sensory and peripheral-nerve dysfunction were common, but proprioceptive acuity and postural balance were unmeasured. Conclusions: IBM progression is best measured by quantitative quadriceps strength and function. Intervention evidence derives largely from small, uncontrolled and neutral trials. Primary myopathy is likely the principal driver of decline, but its downstream consequences—for balance, proprioception, and falls—remain underexplored and are the priority for future study. Full article

Disruptions in folate (vitamin B9) and vitamin B12 metabolism, including nutritional deficiency, folate receptor alpha (FRα) autoantibodies, and MTHFR/DHFR polymorphisms, impair one-carbon metabolism and produce measurable retinal structural, microvascular, and functional changes, offering a non-invasive window into systemic and cerebral metabolic dysfunction, particularly cerebral folate deficiency (CFD). This review synthesizes peer-reviewed evidence on retinal alterations linked to folate/B12 deficiency, hyperhomocysteinemia, FRα autoantibody syndromes, and MTHFR/DHFR variants, alongside artificial intelligence (AI) and machine learning (ML) approaches applied to retinal imaging for metabolic, anemic, and nutritional optic neuropathy detection. Three convergent phenotypes emerge: structural changes (retinal nerve fiber layer and ganglion cell complex thinning, optic disc pallor, chorioretinal atrophy), microvascular abnormalities (reduced vessel density, foveal avascular zone enlargement, capillary dropout), and functional deficits (centrocecal scotoma, dyschromatopsia, reduced contrast sensitivity); they arise from homocysteine-mediated endothelial toxicity, mitochondrial impairment, and eNOS uncoupling. Existing AI/ML models for anemia and optic neuropathy establish technical feasibility but do not target folate-specific phenotypes. We propose a dedicated multimodal ML framework integrating structural, perfusion, functional, and biochemical/genetic data as a research agenda for automated, non-invasive CFD detection. Given the established folate–autism spectrum disorder (ASD) risk association reported in FRAA-positive cohorts, such a framework, once validated, could support prenatal and neonatal screening in FRAA-positive or genetically high-risk pregnancies, enabling earlier leucovorin treatment and reducing neurodevelopmental risk. Full article

Implantable neural probes that can simultaneously possess biocompatibility, electrochemical stability, and high signal fidelity are the core devices in neuroelectrophysiological research. In this article, AlGaN/GaN heterojunction field-effect transistors are used instead of traditional metal microelectrodes to prepare brain nerve probes. By photoelectrochemical etching and optimization of sensing area size, the probes have the maximum transconductance value, i.e., the highest sensitivity, under no gate control. After digital filtering processing, the neural probe achieved a signal-to-noise ratio of 8.04 dB on biological analog signals as low as 50 µV, confirming its ability to detect microvolt-level signals. The ex vivo recording of the bullfrog sciatic nerve further validated its biosensing performance, demonstrating the selective capture of composite action potentials from active neural tissue. Full article

Background/Objectives: Autoimmune nodopathies are a distinct subgroup of immune-mediated peripheral neuropathies caused by antibodies targeting nodal and paranodal proteins, including contactin-1 (CNTN1). These disorders are frequently misclassified as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), despite fundamental differences in pathophysiology, clinical course, and treatment response. Growing evidence indicates that systemic manifestations, such as proteinuria, may represent relevant diagnostic red flags. We report a case of anti-CNTN1 autoimmune nodopathy with renal involvement and long-term follow-up after rituximab therapy. Methods: We describe the longitudinal clinical, electrophysiological, laboratory, and therapeutic features of a patient presenting with an acute/subacute sensory ataxic neuropathy evolving into a chronic immune-mediated disorder. Serial nerve conduction studies were performed during multiple hospital admissions and follow-up visits. Autoantibody testing for nodal/paranodal antigens was undertaken, and systemic biomarkers were monitored over time. Results: The patient initially exhibited a robust response to intravenous immunoglobulin (IVIg), consistent with an acute inflammatory neuropathy. Subsequent relapse was characterized by cranial nerve involvement, worsening sensory ataxia, peripheral edema, albuminocytologic dissociation on cerebrospinal fluid analysis, proteinuria, and an inverted albumin/gamma globulin ratio, redirecting the diagnostic hypothesis toward CIDP. The detection of anti-CNTN1 antibodies ultimately established the diagnosis of autoimmune nodopathy. Owing to poor durability of IVIg, rituximab was initiated, resulting in sustained clinical improvement and near-complete recovery of motor and sensory nerve conduction parameters at one-year follow-up (November 2025). Conclusions: This case emphasizes the diagnostic relevance of extraneurological biomarkers, including proteinuria and peripheral edema, in autoimmune nodopathies and supports early nodal/paranodal antibody testing in atypical demyelinating neuropathies. Prompt B-cell-directed therapy may enable functional recovery of nodal integrity and improve long-term outcomes. Further studies are needed to clarify potential immunological triggers, including anti-IL-23 therapies, in the pathogenesis of anti-CNTN1 autoimmune nodopathy. Full article