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Spinal root and plexus hypertrophy in chronic inflammatory demyelinating polyneuropathy.
A J Duggins1, J G McLeod, J D Pollard
1Institute of Clinical Neurosciences, Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia.
Brain : a Journal of Neurology
|July 2, 1999
Summary
Magnetic resonance imaging (MRI) can reveal spinal root and plexus hypertrophy in chronic inflammatory demyelinating polyneuropathy (CIDP) patients, especially those with long-standing disease. Gadolinium enhancement may indicate active disease in these cases.
Area of Science:
- Neurology
- Radiology
- Immunology
Background:
- Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare autoimmune disorder affecting peripheral nerves.
- MRI is a valuable tool for diagnosing and monitoring neurological conditions.
Observation:
- MRI scans of spinal roots and plexuses were conducted on 14 CIDP patients.
- Hypertrophy of cervical roots and brachial plexus was observed in 8 patients, with 6 also showing lumbar plexus hypertrophy.
Findings:
- Gadolinium enhancement, indicative of active inflammation, was seen in 5 of 6 hypertrophied cases and 1 of 5 non-hypertrophied cases.
- Patients with hypertrophy had a relapsing-remitting disease course and longer duration.
- Nerve biopsy in one case revealed gross onion-bulb formations, consistent with nodular hypertrophy.
Implications:
- Spinal root and plexus hypertrophy are identifiable MRI findings in chronic CIDP.
- MRI findings, including hypertrophy and gadolinium enhancement, can aid in diagnosing and assessing disease activity in CIDP.
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