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Chronic Inflammatory Pure Sensory Polyradiculoneuropathy: A Rare CIDP Variant With Unusual Electrophysiology

Rajabally, Yusuf A. MD, FRCP; Wong, Siew L. MBChB

Journal of Clinical Neuromuscular Disease: March 2012 - Volume 13 - Issue 3 - p 149–152
doi: 10.1097/CND.0b013e31822484fb
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We describe a patient presenting with progressive upper limb numbness and sensory ataxia of the 4 limbs. Motor nerve conduction studies were completely normal. Sensory electrophysiology showed reduced/absent upper limb sensory action potentials (SAPs). In the lower limbs, SAPs were mostly normal. Sensory conduction velocities were normal. Forearm sensory conduction blocks were present for both median nerves on antidromic testing. The maximal recordable sural SAP was preserved in comparison to maximal recordable radial SAP, consistent with an “abnormal radial normal sural” pattern. Somatosensory evoked potentials were unrecordable for tibial and median nerves. Cerebrospinal fluid protein was raised (0.99 g/L). The patient worsened on oral corticosteroids but subsequently made substantial functional recovery on intravenous immunoglobulins. This case is different to those previously reported of sensory chronic inflammatory demyelinating polyradiculoneuropathy, given its exclusive sensory electrophysiologic presentation, presence of predominant upper limb reduced sensory amplitudes, and detection of sensory conduction blocks. These electrophysiologic features were of paramount importance in establishing diagnosis and effective therapy.

Neuromuscular Clinic, Department of Neurology, University Hospitals of Leicester, Leicester General Hospital, Leicester, United Kingdom.

The authors declare no conflict of interest.

Reprints: Dr. Yusuf A. Rajabally, MD, FRCP, Neuromuscular Clinic, Department of Neurology, University Hospitals of Leicester, Leicester General Hospital, Leicester LE5 4PW, United Kingdom (e-mail: yusuf.rajabally@uhl-tr.nhs.uk).

© 2012 Lippincott Williams & Wilkins, Inc.