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Sensory chronic inflammatory demyelinating polyneuropathy: an under-recognized entity?
Xavier Ayrignac1, Karine Viala, Régine Morizot Koutlidis
1Service de Neurologie, CHU Montpellier, Hôpital Gui de Chauliac, 34295, Montpellier, France.
Muscle & Nerve
|February 21, 2013
Summary
Diagnosing sensory chronic inflammatory demyelinating polyneuropathy (CIDP) is challenging. This study identifies key atypical signs and diagnostic tools, showing over 90% of patients respond to immunotherapy.
Area of Science:
- Neurology
- Clinical Neuroscience
- Peripheral Nerve Disorders
Background:
- Sensory chronic inflammatory demyelinating polyneuropathy (CIDP) presents diagnostic challenges.
- Distinguishing CIDP from chronic idiopathic axonal polyneuropathy (CIAP) is often difficult.
Purpose of the Study:
- To identify clinical and electrophysiological features of sensory CIDP.
- To evaluate diagnostic approaches for sensory CIDP.
Main Methods:
- Retrospective analysis of 22 patients with sensory polyneuropathy and atypical signs for CIAP.
- Utilized clinical examination, electrophysiology (SSEPs), CSF analysis, and nerve biopsy.
Main Results:
- Atypical signs included sensory ataxia, areflexia, cranial nerve involvement, and early onset.
- Abnormal SSEPs (100%) and elevated CSF protein (73%) were common.
- Over 90% of patients showed positive response to immunotherapy, confirming sensory CIDP.
Conclusions:
- Sensory CIDP can be misdiagnosed as CIAP.
- Recommend SSEPs and CSF examination for suspected cases with atypical features.
- Nerve biopsy is reserved for complex or inconclusive cases.
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