Focal neuropathy preceding chronic inflammatory demyelinating polyradiculoneuropathy by several years.
We report three patients who exhibited an unusual clinical course of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in which mononeuropathic limb weakness developed 2, 11 and 23 years, respectively, before the development of generalized polyradiculoneuropathy. The eventual diagnosis remained uncertain until other causes of neuropathy were excluded, and the clinical disorder progressed to involve the other limbs. Focal or regional variants of CIDP suggest that the pathologic, and perhaps the immunologic, abnormalities can be localized and selective for prolonged periods of time. Although this clinical variant seems to account for a small number of CIDP cases, its recognition may aid in making an early diagnosis.
Verma
A
A
Department of Neurology, University of Vermont College of Medicine, Burlington.
Tandan
R
R
Adesina
A M
AM
Pendlebury
W W
WW
Fries
T J
TJ
Bradley
W G
WG
D000328:Adult; D000368:Aged; D001706:Biopsy; D003711:Demyelinating Diseases / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D009046:Motor Neurons / Q000502:physiology; D009186:Myelin Sheath / Q000473:pathology; D009431:Neural Conduction / Q000502:physiology; D009443:Neuritis / Q000473:pathology / Q000503:physiopathology*; D010525:Peripheral Nerves / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology*; D011129:Polyradiculoneuropathy / Q000473:pathology / Q000503:physiopathology*; D011930:Reaction Time / Q000502:physiology; D012677:Sensation / Q000502:physiology; D013497:Sural Nerve / Q000473:pathology