CIDP Masquerading as Mononeuritis Multiplex: The Value of MR Neurography

Author Info

Selina Robertson Simon McCrory James Holt

Corresponding Author

James Holt
Neurology Department, The Walton Centre NHS Foundation Trust, Liverpool, UK

A B S T R A C T

Background: We present two patients with the Lewis-Sumner variant of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), charting the diagnostic challenge posed by their clinical presentation and electrodiagnostic findings. The learning points center on the use of magnetic resonance imaging (MRI) in establishing a definitive diagnosis when clinical and neurophysiology data do not otherwise add up. Cases: The first patient presented with slowly progressive asymmetric distal weakness of the lower limbs with wasting, weakness, areflexia and numbness on examination. The second patient experienced stepwise asymmetric hand/forearm weakness with deformity and areflexia, plus mild distal sensory impairment. Neurophysiological studies for both patients were initially most suggestive of mononeuritis multiplex, with no evidence of demyelination. Conclusion: The possibility of asymmetric or multifocal CIDP, the Lewis-Sumner variant, should not be forgotten in suspected mononeuritis multiplex and the value of MRI in such cases is discussed.

Article Info

Article Type

Case Report

Publication history

Received: Mon 26, Apr 2021
Accepted: Wed 12, May 2021
Published: Wed 26, May 2021

Copyright

© 2023 James Holt. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.NNB.2021.02.01