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A high stepping gate implies distal more than proximal weakness. Hammer toes are a finding in Charcot-Marie-Tooth (hereditary motor and sensory) neuropathies, most of which also feature demyelination of peripheral myelin sheaths. Slowing of nerve conduction velocities could have demonstrated the same thing less invasively.?
hardest part for me was differentiating absence of schwann cells vs abnormal myeling sheaths. Schwann cells come from neural crest cells so we would expect to see other neural crest migration issues in my opinion. CMT disease has motor and sensory issues because PMP-22 peripheral myelinating protein is mutated. leads to abnormal myelination of the peripheral nerves. foot drop from sensory degradation, muscle atrophy from motoneuron involvement (also peripherally myelinated)