Quadriparesis in a young man due to chronic inflammatory demyelinating polyneuropathy

A man of 30 years, admitted in Neurology unit of Mymensingh Medical College Hospital with weakness of all four limbs for 4 weeks which was of gradual onset and progressive. He had no difficulty in vision, swallowing & speech. He had no disturbances of sensation, bowel & bladder functions. There was no preceding history of gastrointestinal or upper respiratory tract infection or vaccination. General examination was normal except the presence of hypertension detected two months before the onset of current illness. All cranial nerve functions were intact. Muscle power was grade 4 in all limbs and the reflexes were absent. All modalities of sensation and coordination were normal. Cerebro-spinal fluid (CSF) study revealed protein-cell dissociation. Electro physiologic findings were consistent with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). The patient was treated with prednisolone 60mg/day for two months with improvement of muscle power. The steroid was reduced gradually and then maintained 20mg/day without any relapse.