Trigeminal nerve hypertrophy in chronic inflammatory demyelinating polyradiculoneuropathy

Area of Science:

• Neurology
• Pathology

Background:

• Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare autoimmune disorder affecting peripheral nerves.
• Nerve hypertrophy is not a typical clinical feature of CIDP.

Observation:

• A patient with a 13-year history of CIDP presented with new neurological symptoms.
• Symptoms included diplopia (double vision) and proptosis (bulging eyes).

Findings:

• Neuraxis imaging revealed significant bilateral trigeminal nerve hypertrophy.
• Enlargement of lumbosacral nerve roots was also observed.
• Infraorbital nerve biopsy showed inflammatory infiltrates and onion bulb formations, characteristic of CIDP.

Implications:

• This case expands the understanding of CIDP's clinical spectrum.
• Highlights nerve hypertrophy as a potential, albeit rare, manifestation of CIDP.
• Suggests the importance of considering nerve hypertrophy in the differential diagnosis of CIDP with specific imaging findings.