Chronic inflammatory demyelinating polyradiculoneuropathy presenting as cauda equina syndrome in a diabetic.
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) may occur in association with diabetes mellitus (DM). We report a case of a poorly controlled diabetic patient who presented with rapid onset of bilateral lower extremity weakness and sensory loss associated with sacral and posterior thigh paresthesias and urinary and bowel incontinence, indicative of cauda equina syndrome (CES). Subsequent evaluation was consistent with CIDP. Monthly infusions with intravenous immunoglobulins (IVIg) with strict glycemic control using insulin resulted in remarkable clinical and electrophysiological recovery. This case report describes a rare presentation of CIDP and emphasizes the importance of early utility of electrodiagnostic (EDX) studies in the clinical evaluation of diabetic patients presenting with rapidly progressive lower extremity weakness and sensory loss associated with diminished reflexes.
Lai
Wayne W L
WW
Neurology Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio 44106-1703, United States.
Ubogu
Eroboghene E
EE
D000368:Aged; D002490:Central Nervous System / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000276:immunology / Q000473:pathology / Q000503:physiopathology*; D003937:Diagnosis, Differential; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D018908:Muscle Weakness / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010291:Paresis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D010525:Peripheral Nerves / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D011128:Polyradiculopathy / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D020886:Somatosensory Disorders / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome; D014555:Urination Disorders / Q000209:etiology / Q000473:pathology / Q000503:physiopathology
D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid