Tomaculous neuropathy in an airline pilot.

Tomaculous neuropathy is an infrequently reported cause of peripheral neuropathy. It typically represents an inherited condition, although de novo chromosomal mutations have been reported. The condition may be easily confused with other sensorineural neuropathies unless a high degree of suspicion is maintained and a thorough clinical evaluation is performed. The condition is likely under-diagnosed and underreported because of its episodic, transient nature and the extensive differential diagnoses. This condition rarely leads to significant physical incapacitation; however, as evidenced in this case, the degree of limitation could lead to transient occupational incapacitation with definite implications for aeromedical certification.