Skip to main content
AAN.com
Views & Reviews
May 1, 1996

Chronic inflammatory demyelinating polyradiculoneuropathy
Unusual clinical features and therapeutic responses

May 1996 issue
46 (5) 1206

Abstract

We present three patients with atypical chronic inflammatory demyelinating polyradiculoneuropathy and discuss the management of patients who appear treatment resistant or present with unusual manifestations. The clinical features of the patients included massive nerve root hypertrophy causing myelopathy and movement-provoked paresthesia, pupillary dysfunction, visual loss due to increased intracranial pressure, and focal brachial plexus involvement. Each patient ultimately required prolonged courses of immune modulating therapy before benefit was attained, illustrating the importance of intensive and prolonged treatment combined with objective assessment of response to therapy.

Get full access to this article

View all available purchase options and get full access to this article.

References

1.
Dyck PJ, Lais AC, Ohta M, Bastron JA, Okazaki H, Groover RV. Chronic inflammatory polyradiculoneuropathy. Mayo Clin Proc 1975; 50:621–637.
2.
Barohn RJ, Kissel JT, Warmolts JR, Mendell JR. Chronic inflammatory demyelinating polyradiculoneuropathy: clinical characteristics, course, and recommendations for diagnostic criteria. Arch Neurol 1989;46:878–884.
3.
McCombe PA, Pollard JD, McLeod JG. Chronic inflammatory demyelinating polyradiculoneuropathy. Brain 1987;110:1617–1630.
4.
Austin JH. Observations on the syndrome of hypertrophic neuritis (the hypertrophic interstitial radiculo-neuropathies). Medicine 1956; 35:187–237.
5.
Harris WD, Newcomb WD. A case of relapsing interstitial hypertrophic polyneuritis. Brain 1929;52:108–116.
6.
Symonds CP, Blackwood W. Spinal cord compression in hypertrophic neuritis. Brain 1962;85:251–260.
7.
Dyck PJ, Sherman WR, Hallcher LM, et al. Human diabetic endoneurial sorbitol, fructose, and myo-inositol related to sural nerve morphometry. Ann Neurol 1980;8:590–596.
8.
Fantin A, Feist RM, Reddy CV. Intracranial hypertension and papilloedema in chronic inflammatory demyelinating polyneuropathy. Br J Ophthalmol 1993;77:193.
9.
Buchsbaum HW, Gallo AE Jr. Polyneuritis, papilledema, and lumboperitoneal shunt. Arch Neurol 1969;21:253–257.
10.
Garcin R, Gruner J, Man HX. Documents pour servir a l'etude pathogenique du signe d'Argyll-Robertson dans la nevrite hypertrophique de Dejerine-Sottas. Bull Acad Natl Med 1959;143:499–508.
11.
Adams RD, Asbury AK, Michelsen JJ. Multifocal pseudohypertrophic neuropathy. Trans Am Neurol Assoc 1965;90:30–34.
12.
Rosen SA, Wang H, Cornblath DR, Uematsu S, Hurko 0. Compression syndromes due to hypertrophic nerve roots in hereditary motor sensory neuropathy type I. Neurology 1989; 39:1173–1177.
13.
De Silva RN, Willison HJ, Doyle D, Weir AI, Hadley DM, Thomas AM. Nerve root hypertrophy in chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 1994; 17:168–170.
14.
Ginsberg L, Platts AD, Thomas PK. Chronic inflammatory demyelinating polyneuropathy mimicking a lumbar spinal stenosis syndrome. J Neurol Neurosurg Psychiatry 1995; 59:189–191.
15.
Bertorini T, Halford H, Lawrence J, Vo D, Wassef M. Contrast-enhanced magnetic resonance imaging of the lumbosama1 roots in the dysimmune inflammatory polyneuropathies. J Neuroimaging 1995; 5:9–15.
16.
Cusimano MD, Bilbao JM, Cohen SM. Hypertrophic brachial plexus neuritis: A pathological study of two cases. Ann Neurol 1988; 24:615–622.
17.
Lewis RA, Sumner AJ, Brown MJ, Asbury AK. Multifocal demyelinating neuropathy with persistent conduction block. Neurology 1982; 32:958–964.
18.
Bradley WG, Bennet RK, Good P, Little B. Proximal chronic inflammatory polyneuropathy with multifocal conduction block. Arch Neurol 1988; 45:451–455.
19.
Donofrio PD, Tandan R, Albers JW. Plasma exchange in chronic inflammatory demyelinating polyradiculoneuropathy. Muscle Nerve 1985; 8:321–327.
20.
Gibbels E, Toyka KV, Borberg H, Haupt WF, Hann P. Plasmaaustauschbehandlung bei chronischen polyneuritiden vom typ Guillain-Barre. Nervenarzt 1986;57:129–139.
21.
Van Doorn PA, Vermeulen M, Brand A, Mulder PGH, Busch HFM. Intravenous immunoglobulin treatment in patients with chronic inflammatory demyelinating polyneuropathy: clinical and laboratory characteristics associated with improvement. Arch Neurol 1991; 48:217–220.
22.
Dyck PJ, Daube J, O'Brien P, et al. Plasma exchange in chronic inflammatory demyelinating polyradiculoneuropathy. N Engl J Med 1986;314:461–465.
23.
Dyck PJ, Litchy WJ, Kratz KM, et al. A plasma exchange versus immune globulin infusion trial in chronic inflammatory demyelinating polyradiculoneuropathy. Ann Neurol 1994; 36:838–845.
24.
Dyck PJ, O'Brien PC, Oviatt KF, et al. Prednisone improves chronic inflammatory demyelinating polyradiculoneuropathy more than no treatment. Ann Neurol 1982; 11:136–141.
25.
Vermeulen M, van Doorn PA, Brand A, Strengers PF, Jennekens FG, Busch HF. Intravenous immunoglobulin treatment in patients with chronic inflammatory demyelinating polyneuropathy: a double blind, placebo controlled study. J Neurol Neurosurg Psychiatry 1993; 56:36–39.
26.
Dyck PJ, Kratz KM, Lehman KA, et al. The Rochester Diabetic Neuropathy Study: design, criteria for types of neuropathy, selection bias, and reproducibility of neuropathic tests. Neurology 1991; 41:799–807.
27.
Dyck PJ, Litchy WJ, Lehman KA, Hokanson JL, Low PA, O'Brien PC. Variables influencing neuropathic endpoints: The Rochester diabetic neuropathy study of healthy subjects. Neurology 1995; 45:1115–1121.

Information & Authors

Information

Published In

Neurology®
Volume 46Number 5May 1996
Pages: 1206
PubMed: 8628454

Publication History

Published online: May 1, 1996
Published in print: May 1996

Permissions

Request permissions for this article.

Authors

Affiliations & Disclosures

Gyl Midroni, MD
Peripheral Neuropathy Research Center, Mayo Clinic and Mayo Foundation, Rochester, MN.
Peter James Dyck, MD
Peripheral Neuropathy Research Center, Mayo Clinic and Mayo Foundation, Rochester, MN.

Notes

Address correspondence and reprint requests to Dr. Peter James Dyck, Mayo Clinic, 200 First Street, S.W., Rochester, MN 55905.

Metrics & Citations

Metrics

Citation information is sourced from Crossref Cited-by service.

Citations

Download Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Select your manager software from the list below and click Download.

Cited By
  1. Original Surgical Treatment and Long-term Follow-up for Chronic Inflammatory Demyelinating Polyradiculoneuropathy Causing a Compressive Cervical Myelopathy: Review of the Literature, Neurospine, 19, 2, (472-477), (2022).https://doi.org/10.14245/ns.2143232.616
    Crossref
  2. Chronic inflammatory demyelinating polyradiculoneuropathy with myelopathy due to massively enlarged nerve roots著明な神経根腫大により脊髄症を呈した慢性炎症性脱髄性多発根神経炎の77歳男性例, Rinsho Shinkeigaku, 60, 9, (603-608), (2020).https://doi.org/10.5692/clinicalneurol.cn-001416
    Crossref
  3. Papilledema in Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP): A Pediatric Case and Review of the Literature, Journal of Child Neurology, 35, 10, (700-704), (2020).https://doi.org/10.1177/0883073820925302
    Crossref
  4. Hydrocephalus due to marked enlargement of spinal roots in a patient with chronic inflammatory demyelinating polyradiculoneuropathy, European Journal of Neurology, 27, 11, (2385-2388), (2020).https://doi.org/10.1111/ene.14492
    Crossref
  5. Tonic pupils: an unusual autonomic involvement in chronic inflammatory demyelinating polyneuropathy (CIDP), Neurological Sciences, 40, 8, (1725-1727), (2019).https://doi.org/10.1007/s10072-019-03890-8
    Crossref
  6. A treatable hypertrophic neuropathy, Practical Neurology, 19, 1, (80-82), (2018).https://doi.org/10.1136/practneurol-2018-002083
    Crossref
  7. Lumbar plexus in patients with chronic inflammatory demyelinating polyneuropathy: Evaluation with 3D nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement imaging (3D SHINKEI), European Journal of Radiology, 93, (95-99), (2017).https://doi.org/10.1016/j.ejrad.2017.05.031
    Crossref
  8. Chronic Inflammatory Demyelinating Polyradiculoneuropathy, Neuromuscular Disorders, (441-452), (2017).https://doi.org/10.1007/978-981-10-5361-0_38
    Crossref
  9. Contribution of plexus MRI in the diagnosis of atypical chronic inflammatory demyelinating polyneuropathies, Journal of the Neurological Sciences, 360, (170-175), (2016).https://doi.org/10.1016/j.jns.2015.11.048
    Crossref
  10. A case of POEMS and chronic papilledema with preserved optic nerve function, Canadian Journal of Ophthalmology, 51, 1, (e8-e10), (2016).https://doi.org/10.1016/j.jcjo.2015.08.015
    Crossref
  11. See more
Loading...

View Options

Login options

Check if you have access through your login credentials or your institution to get full access on this article.

Personal login Institutional Login
Purchase Options

The neurology.org payment platform is currently offline. Our technical team is working as quickly as possible to restore service.

If you need immediate support or to place an order, please call or email customer service:

  • 1-800-638-3030 for U.S. customers - 8:30 - 7 pm ET (M-F)
  • 1-301-223-2300 for customers outside the U.S. - 8:30 - 7 pm ET (M-F)
  • [email protected]

We appreciate your patience during this time and apologize for any inconvenience.

View options

PDF and All Supplements

Download PDF and Supplementary Material

Full Text

View Full Text

Full Text HTML

View Full Text HTML

Media

Figures

Other

Tables

Share

Share

Share article link

Share