Facial and trigeminal neuropathies as the initial manifestation of chronic inflammatory demyelinating polyradiculopathy.
OBJECTIVE
To report the clinical and electrophysiological features of a patient who presented with facial weakness and numbness as the initial manifestation of Chronic inflammatory demyelinating polyradiculopathy (CIDP).


METHODS
An 83-year-old woman presented with facial numbness and weakness. Examination demonstrated mild facial weakness with no other cranial abnormalities. Blink and jaw-jerk reflex latencies were prolonged bilaterally; myokymic discharges were seen in the right frontalis. Cerebrospinal fluid demonstrated an elevated protein. After 3 weeks of intravenous immunoglobulin treatment, the symptoms and electrophysiological findings improved but the symptoms recurred and became more generalized after cessation of intravenous immunoglobulin.


CONCLUSIONS
This case represents a patient with an unusual initial presentation of cranial nerve involvement in CIDP. Blink reflexes may be a useful electrophysiological technique to assess for peripheral nerve demyelination in patients with suspected CIDP.
Varela
Heber
H
Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA.
Rubin
Devon I
DI
D000369:Aged, 80 and over; D004594:Electrophysiology / Q000379:methods; D005155:Facial Nerve Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D009431:Neural Conduction / Q000502:physiology; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000150:complications*; D012018:Reflex / Q000502:physiology; D020433:Trigeminal Nerve Diseases / Q000209:etiology*