Korean J Clin Neurophysiol.  2013 Jun;15(1):13-18. 10.14253/kjcn.2013.15.1.13.

Subacute Inflammatory Demyelinating Polyneuropathy Combined with Optic Neuritis

Affiliations
  • 1Department of Neurology, Inje University Haeundae Paik Hospital, Busan, Korea. neurof@naver.com
  • 2Department of Neurology, Dong-A University Hospital, Busan, Korea.

Abstract

It was sometimes difficult to differentiate between acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) and subacute inflammatory demyelinating polyneuropathy (SIDP). The CNS involvement of these polyneuropathies has rarely reported in the literature. We present the case of a 42-year-old man who developed rapidly developing inflammatory demyelinating polyneuropathy followed by right optic neuritis. This case showed progressive motor weakness and sensory dysfunction with time to nadir at 8 weeks, demyelination in nerve conduction study, no other etiology of neuropathy, no relapse during follow-up of 18 months, good response to steroid and complete recovery which favor SIDP more than A-CIDP. We experienced the case of SIDP associated with optic neuritis.

Keyword

Subacute inflammatory demyelinating polyneuropathy; Optic neuritis; Acute-onset chronic inflammatory demyelinating polyneuropath

MeSH Terms

Demyelinating Diseases
Follow-Up Studies
Neural Conduction
Optic Neuritis
Polyneuropathies
Recurrence

Figure

  • Figure 1. Brain MRI of patient. Fat suppression T1 post-gadolinium scan showed the edema and enhancement of the right optic nerve (arrow) (A: axial, B: coronal).

  • Figure 2. Pattern shift visual evoked potential of patient. The graph showed “W” shaped P100 wave formation and bilateral prolonged P100 latency at onset of optic neuritis (A), and normal wave formation and prolonged P 100 latency bilaterally after 16 months (B). LO; left occipital, Fz; fontal zero, MO; midline occipital, RO; right occipital, ON; optic neuritis.


Reference

1.Oh SJ., Kurokawa K., de Almeida DF., Ryan HF Jr., Claussen GC. Subacute inflammatory demyelinating polyneuropathy. Neurology. 2003. 61:1507–1512.
Article
2.Laura M., Leong W., Murray NM., Ingle G., Miszkiel KA., Altmann DR, et al. Chronic inflammatory demyelinating polyradiculoneuropathy: MRI study of brain and spinal cord. Neurology. 2005. 64:914–916.
Article
3.Stojkovic T., de Seze J., Hurtevent JF., Arndt C., Beaume A., Hache JC, et al. Visual evoked potentials study in chronic idiopathic inflammatory demyelinating polyneuropathy. Clin Neurophysiol. 2000. 111:2285–2291.
Article
4.Gartzen K., Katzarava Z., Diener HC., Putzki N. Peripheral nervous system involvement in multiple sclerosis. Eur J Neurol. 2011. 18:789–791.
Article
5.Misawa S., Kuwabara S., Mori M., Hayakawa S., Sawai S., Hattori T. Peripheral nerve demyelination in multiple sclerosis. Clin Neurophysiol. 2008. 119:1829–1833.
Article
6.Holtkamp M., Zschenderlein R., Bruck W., Weber JR. Chronic inflammatory demyelinating polyradiculoneuropathy with histologically proven optic neuritis. Acta Neuropathol. 2001. 101:529–531.
Article
7.Berger T., Weerth S., Kojima K., Linington C., Wekerle H., Lassmann H. Experimental autoimmune encephalomyelitis: the antigen specificity of T lymphocytes determines the topography of lesions in the central and peripheral nervous system. Lab Invest. 1997. 76:355–364.
8.Ruts L., Drenthen J., Jacobs BC., van Doorn PA. Distinguishing acute-onset CIDP from fluctuating Guillain-Barre syndrome: a prospective study. Neurology. 2010. 74:1680–1686. 9. Chowdhury D, Arora A. Axonal Guillain-Barre syndrome: a critical review. Acta Neurol Scand 2001;103: 267-277.
Article
9.Kim DH., Yoon YC., Lee KK., Kwon OS. Guillain-Barre syndromes accompanied by optic neuritis. J Korean Neurol Assoc. 1997. 15:1199–1202.
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