Neuromuscular

PERIPHERAL NERVE: Tomaculous Neuropathy

Differential Diagnosis
Also see: HNPP pathology

MYELIN PATHOLOGY: Teased fibers




Tomaculae: Focal myelin thickening
  Common in HNPP
  Paranodal demyelination (Lower axon)


TOMACULAE: Ultrastructure
from R Schmidt



Thickened myelin sheath due to multiple layers of folded myelin



Folding of myelin sheath: Outside axon or invaginating into axon (Right)


Low power view:
Two axons with tomaculae
One thinly myelinated axon

Thickened myelin sheath




Return to Chronic demyelination
Return to Normal nerve biosies
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1/8/2013