Chronic inflammatory demyelinating polyradiculoneuropathy associated with multiple sclerosis

Khema R. Sharma, Daniela Saadia, Alicia G. Facca, Rita Bhatia, Doraiswami R. Ayyar, William Sheremata

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Objective: To describe temporal profile of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in patients with definite, relapsing multiple sclerosis (MS). Background: Peripheral demyelinating neuropathy has been rarely reported in association with central nervous system demyelinating disorder indistinguishable from MS. Methods: In addition to usual diagnostic studies for CIDP and MS in all 5 patients, we studied proximal segments of nerves using deep tendon reflex latency measurements of biceps reflex, patellar reflex, and ankle reflex. Results: All patients with MS subsequently (4-22 years) developed definite CIDP. Two of these patients developed multiple cranial nerve and spinal root enhancement on subsequent imaging without new intraparenchymal enhancement after a diagnosis of CIDP. The deep tendon reflex latencies were prolonged at more than 2 sites in all patients. Cerebral spinal fluid protein increased (70 ± 19 to 144.8 ± 17.4 mg/dL, P ≤ 0.0001) at time of diagnosis of CIDP. Clinical improvement was observed in all patients after intravenous immunoglobulin therapy. Conclusions: When patients with MS develop CIDP, manifestations of central and peripheral disease involvement seem to respond to intravenous immunoglobulin. These cases suggest that there may be common antigenic targets in central and peripheral nervous system in this subset of patients.

Original languageEnglish (US)
Pages (from-to)385-396
Number of pages12
JournalJournal of clinical neuromuscular disease
Volume9
Issue number4
DOIs
StatePublished - Jun 1 2008

Keywords

  • Chronic inflammatory demyelinating polyradiculopathy
  • Electromyographic reflexes
  • Intravenous immunoglobulin therapy
  • Multiple sclerosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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