Sign Up for a Free Account

This is an image preview.
Start a Free Account
to view the full image.

  • Nearly 3,000 illustrations, including video clips of neurologic disorders.

  • Every article is reviewed by our esteemed Editorial Board for accuracy and currency.

  • Full spectrum of neurology in 1,200 comprehensive articles.

  • Listen to MedLink on the go with Audio versions of each article.

Tomaculous neuropathy classical findings

(A) Semithin cross-section shows a marked depletion of myelinated nerve fibers. Several myelinated fibers have a thick myelin sheath and an irregular contour, suggesting that they are tomacula. (B) Teased fibers reveal globular expansions of myelin measuring 30 µm to 50 µm in length located in both the paranodal and internodal regions. (C) Ultrathin sections demonstrate that the tomacula consists of closely apposed, redundant loops of myelin sheath wound around a myelinated fiber. Layers of uncompacted myelin lamellae are apparent. A redundant circle of myelin is present embedded in the myelin sheath. (Contributed by Dr. Florian Thomas.)

Related Media

Associated Disorders

  • Carpal tunnel syndrome
  • Charcot-Marie-Tooth disease
  • Hereditary motor and sensory neuropathy