CIDP presenting as recurrent severe back pain without weakness or sensory loss.
A 71-year-old woman presented with severe back pain, limb weakness and cranial nerve dysfunction associated with high cerebrospinal fluid (CSF) protein; we diagnosed Guillain-Barré syndrome and her symptoms completely resolved after intravenous immunoglobulin. Over the next 4 years, she had three further episodes of excruciating back pain accompanied by raised CSF protein, but without weakness, sensory loss, or abnormalities in routine nerve conduction studies. Sensory evoked potentials suggested proximal demyelination and lumbosacral plexus imaging suggested inflammation. We argue that this is a relapsing proximal polyradiculoneuropathy on the spectrum of chronic inflammatory demyelinating polyradiculoneuropathy.
Wessex Neurological Centre, University Hospital Southampton, Southampton, UK.
Dirk
D
Bäumer
Department of Neuroradiology, John Radcliffe Hospital, Oxford, UK.
David James
DJ
Grant
Department of Clinical Neurophysiology, John Radcliffe Hospital, Oxford, UK.
Ravi
R
Knight
Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
Camilla
C
Buckley
Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
David
D
Bennett
Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
Simon
S
Rinaldi
D000368:Aged; D001416:Back Pain / Q000209:etiology*; D005260:Female; D020275:Guillain-Barre Syndrome / Q000175:diagnosis; D006801:Humans; D016756:Immunoglobulins, Intravenous; D018908:Muscle Weakness; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy
D016756:Immunoglobulins, Intravenous
GUILLAIN-BARRE SYNDROME; NEUROIMMUNOLOGY; NEUROPATHY