title: Sensory chronic inflammatory demyelinating polyneuropathy: an under-recognized entity?
abstract: BACKGROUND
  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.
authors: Service de Neurologie, CHU Montpellier, Hôpital Gui de Chauliac, 34295, Montpellier, France.
authors: Xavier
authors: X
authors: Ayrignac
authors: Karine
authors: K
authors: Viala
authors: Régine Morizot
authors: RM
authors: Koutlidis
authors: Guillaume
authors: G
authors: Taïeb
authors: Tanya
authors: T
authors: Stojkovic
authors: Lucille
authors: L
authors: Musset
authors: Jean-Marc
authors: JM
authors: Léger
authors: Emmanuel
authors: E
authors: Fournier
authors: Thierry
authors: T
authors: Maisonobe
authors: Pierre
authors: P
authors: Bouche
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011115:Polyneuropathies / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology*; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: chronic idiopathic axonal polyneuropathy; chronic immune demyelinating polyneuropathy; chronic immune sensory polyradiculopathy; sensory CIDP; somatosensory evoked potentials