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[Chronic inflammatory demyelinating polyradiculoneuropathy presenting localized radiculopathy as an initial symptom]
S Kuwabara1, M Kawamura, K Nagumo
1Department of Neurology, School of Medicine, Chiba University.
Rinsho Shinkeigaku = Clinical Neurology
|March 1, 1991
Summary
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) can initially mimic localized radiculopathy. This case highlights CIDP
Area of Science:
- Neurology
- Clinical Neuroscience
Background:
- Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare autoimmune disorder affecting peripheral nerves.
- CIDP typically presents with symmetrical, progressive weakness and sensory loss.
Observation:
- A 38-year-old man initially presented with unilateral leg muscle atrophy and sensory deficits mimicking localized radiculopathy.
- Diagnostic imaging (MRI, myelography) was negative for spinal cord compression.
- Subsequent progression revealed features consistent with polyneuropathy, including distal weakness, sensory loss, and areflexia.
Findings:
- Nerve conduction studies showed prolonged F-responses and focal conduction blocks, characteristic of demyelinating polyneuropathy.
- Cerebrospinal fluid analysis revealed elevated protein levels (177 mg/dl) with no cells.
- Sural nerve biopsy indicated a loss of large myelinated fibers and presence of thin myelinated fibers.
Implications:
- This case demonstrates that CIDP can present with localized radiculopathy as an initial symptom.
- Recognizing varied onset patterns is crucial for timely CIDP diagnosis and management.
- Highlights the importance of considering CIDP in patients with atypical initial neurological presentations.