Sensory chronic inflammatory demyelinating polyneuropathy: An under-recognized entity?
| Autor: | Emmanuel Fournier, Xavier Ayrignac, Karine Viala, L. Musset, Thierry Maisonobe, Guillaume Taieb, Régine Morizot Koutlidis, Jean-Marc Léger, Tanya Stojkovic, Pierre Bouche |
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| Rok vydání: | 2013 |
| Předmět: |
Pathology
medicine.medical_specialty Nerve biopsy medicine.diagnostic_test Physiology business.industry Chronic inflammatory demyelinating polyneuropathy Sensory system medicine.disease Axonal polyneuropathy Cellular and Molecular Neuroscience Cerebrospinal fluid medicine.anatomical_structure Sensory ataxia Somatosensory evoked potential Physiology (medical) medicine Neurology (clinical) medicine.symptom business Sensory nerve |
| Zdroj: | Muscle & Nerve. 48:727-732 |
| ISSN: | 0148-639X |
| DOI: | 10.1002/mus.23821 |
| Popis: | Introduction Sensory chronic inflammatory demyelinating polyneuropathy (CIDP) can be difficult to diagnose. Methods We report 22 patients with chronic sensory polyneuropathy with ≥1 clinical sign atypical for chronic idiopathic axonal polyneuropathy (CIAP) but no electrodiagnostic criteria for CIDP. Results Clinical signs atypical for CIAP were: sensory ataxia (59%), generalized areflexia (36%), cranial nerve involvement (32%), rapid upper limb involvement (40%), and age at onset ≤55 years (50%). Additional features were: normal sensory nerve action potentials (36%), abnormal radial/normal sural pattern (23%), abnormal somatosensory evoked potentials (SSEPs) (100%), elevated cerebrospinal fluid (CSF) protein (73%), and demyelinating features in 5/7 nerve biopsies. Over 90% of patients responded to immunotherapy. We conclude that all patients had sensory CIDP. Conclusions Sensory CIDP patients can be misdiagnosed as having CIAP. If atypical clinical/electrophysiologic features are present, we recommend performing SSEPs and CSF examination. Nerve biopsy should be restricted to disabled patients if other examinations are inconclusive. Muscle Nerve 48:727–732, 2013 |
| Databáze: | OpenAIRE |
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