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Chronic inflammatory demyelinating polyradiculoneuropathy presenting as predominantly sciatic monomelic neuropathy
Shadi El-Wahsh1,2, Cecilia Cappelen-Smith2,3, Judith Spies1,4
1Department of Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
BMJ Neurology Open
|March 8, 2021
Summary
This case study highlights a rare focal lower limb variant of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). Lumbosacral plexus MRI is crucial for diagnosing this atypical presentation of CIDP.
Area of Science:
- Neurology
- Clinical Neuroscience
Background:
- Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a frequent, yet often overlooked, cause of treatable chronic sensorimotor neuropathy.
- Classical CIDP presents with symmetrical proximal and distal weakness, sensory issues, and reduced reflexes persisting over two months.
Purpose of the Study:
- To present a case of isolated lower limb CIDP, emphasizing its focal variant.
- To highlight the diagnostic utility of lumbosacral plexus MRI in identifying this atypical CIDP presentation.
Main Methods:
- Diagnosis of CIDP relies on electrodiagnostic studies and biopsy confirming demyelination per established criteria.
- Atypical CIDP presentations can complicate diagnosis, necessitating advanced imaging.
Main Results:
- The study details a case of CIDP manifesting solely in the lower limbs, a focal variant.
- Lumbosacral plexus MRI proved significant in diagnosing this specific case of lower limb CIDP.
Conclusions:
- Focal CIDP, characterized by chronic monomelic neuropathy, warrants consideration in clinical practice.
- Diagnostic workup for suspected focal CIDP should include electrodiagnostic studies, lumbar puncture, nerve biopsy, and MRI of nerve roots and plexuses.
