Ann Clin Neurophysiol.  2022;24(2):59-62. 10.14253/acn.2022.24.2.59.

Optic neuritis and multiple cranial neuropathies in patient with chronic inflammatory demyelinating polyneuropathy

• Bae MJ
• Lee J
• Eun JI
• Shin KJ

• KMID: 2535719
• DOI: http://doi.org/10.14253/acn.2022.24.2.59

Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic recurrent acquired immune-mediated disease of the peripheral nerves that presents with progressive sensory and motor deficits in all four limbs. Cranial nerve involvement is not as common as in Guillain-Barre syndrome, and central nervous system involvement including optic neuritis has rarely been reported in patients with CIDP. We recently experienced a case with classic CIDP involving bilateral facial and trigeminal nerves, right lower cranial nerves, and the right optic nerve.

Keyword

Optic neuritis; Cranial nerve diseases; Polyradiculoneuropathy; Chronic inflammatory demyelinating

Figure

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  Fig. 1. Findings of electrophysiological studies and brain magnetic resonance imaging (MRI) of the case. (A) Motor nerve conduction studies of both facial nerves showed delayed terminal latency on the right side and decreased compound muscle action potential amplitudes on both sides. (B) The blink reflex test showed delayed latencies of ipsilateral R1 and R2 waves and contralateral R2 waves in both supraorbital stimulations. Axial T1-weighted postcontrast brain MRI showed signal enhancement in the (C) right optic nerve (arrow), (D) right trigeminal nerve (arrow), and (E) cisternal segments of the left trigeminal nerve (arrow). (F) Coronal T2-weighted fluid-attenuated inversion recovery brain MRI showed asymmetric physical enlargement and increased signal intensities of the right glossopharyngeal nerve, vagus nerve, and spinal accessory nerve complex (arrow).

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