Multifocal acquired demyelinating sensory and motor neuropathy misdiagnosed as carpal tunnel syndrome: a case report
Bibliographic record
Abstract
Multifocal acquired demyelinating sensory and motor neuropathy (MADSAM), a subtype of chronic inflammatory demyelinating polyneuropathy, is a non-compressive peripheral nerve disorder. Symptoms of MADSAM include asymmetrical weakness and sensory deficits in the distribution of individual peripheral nerves, which are frequently noted in the distal portion of peripheral nerves. MADSAM can be easily misdiagnosed as any of the various compressive peripheral neuropathies. Here, we present a case of MADSAM misdiagnosed as carpal tunnel syndrome (CTS). A 53-year-old woman had bilateral asymmetrical hand weakness (left hand: significant weakness, right hand: slight motor weakness) and a slight weakness of her bilateral lower extremities. Sensory deficit was found on the volar side of her left hand. She had visited many clinics previously and was diagnosed with CTS. However, an electrodiagnostic study performed in our hospital did not identify CTS but indicated a demyelinating peripheral neuropathy in all limbs. On the basis of the patient's clinical symptoms and laboratory findings, she was diagnosed with MADSAM. When patients exhibit progressive aggravating motor weakness and sensory deficits in more than one distal limb without a specific finding of compressive neuropathy in electrodiagnostic studies, clinicians should consider the possibility of MADSAM.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.005 | 0.003 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.008 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".