• Title/Summary/Keyword: Demyelinating

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Subacute Inflammatory Demyelinating Polyneuropathy Combined with Optic Neuritis (시신경염이 동반된 아급성염증탈수초다발신경병)

  • Kim, Sieun;Park, Kang Min;Park, Jinse;Ha, Sam Yeol;Kim, Sung Eun;Kim, Jong Kuk;Shin, Kyong Jin
    • Annals of Clinical Neurophysiology
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    • v.15 no.1
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    • pp.13-18
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    • 2013
  • 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.

Myelin oligodendrocyte glycoprotein antibody-associated disorders: clinical spectrum, diagnostic evaluation, and treatment options

  • Lee, Yun-Jin;Nam, Sang Ook;Ko, Ara;Kong, JuHyun;Byun, Shin Yun
    • Clinical and Experimental Pediatrics
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    • v.64 no.3
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    • pp.103-110
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    • 2021
  • Inflammatory or immune-mediated demyelinating central nervous system (CNS) syndromes include a broad spectrum of clinical phenotype and different overlapping diseases. Antibodies against myelin oligodendrocyte glycoprotein (MOG-Ab) have been found in some cases of these demyelinating diseases, particularly in children. MOG-Ab is associated with a wider clinical phenotype not limited to neuromyelitis optica spectrum disorder, with most patients presenting with optic neuritis, acute disseminated encephalomyelitis (ADEM) or ADEM-like encephalitis with brain demyelinating lesions, and/or myelitis. Using specific cell-based assays, MOG-Ab is becoming a potential biomarker of inflammatory demyelinating disorders of the CNS. A humoral immune reaction against MOG was recently found in monophasic diseases and recurrent/multiphasic clinical progression, particularly in pediatric patients. This review summarizes the data regarding MOG-Ab as an impending biological marker for discriminating between these diverse demyelinating CNS diseases and discusses recent developments, clinical applications, and findings regarding the immunopathogenesis of MOG-Ab-associated disorders.

Insight into the prognostic factors of chronic inflammatory demyelinating polyneuropathy

  • Baek, Seol-Hee
    • Annals of Clinical Neurophysiology
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    • v.22 no.1
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    • pp.8-12
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    • 2020
  • Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy with heterogeneous features. Appropriate treatment will produce a favorable outcome, but a poor treatment response and severe disability have also been reported. The roles of the clinical phenotypes and electrophysiological features of CIDP as well as of autoantibodies against nodal and paranodal proteins have been highlighted previously due to their association with the treatment response and long-term prognosis. This review addresses the diverse factors associated with the prognosis of CIDP.

Electrophysiological and radiological evidence for the multifocal nature of a case of multifocal acquired demyelinating sensory and motor neuropathy

  • Seong, Gi-Hun;Bae, Jong Seok;Ryu, Sanghyo
    • Annals of Clinical Neurophysiology
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    • v.20 no.2
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    • pp.101-104
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    • 2018
  • Multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy is a variant of chronic acquired demyelinating polyneuropathy. A 65-year-old women presented with upper arm weakness. A nerve conduction study showed conduction blocks over intermediate segments with sparing of distal compound action potentials. Magnetic resonance imaging revealed asymmetric hypertrophy of the brachial plexus on the affected side. These findings represent important electrophysiological and radiological evidence of MADSAM neuropathy. The condition of the patient began to improve after starting intravenous immunoglobulin administration.

Distal acquired demyelinating symmetric neuropathy associated with anti-GM1 and anti-GD1b antibodies

  • Ko, Keun Hyuk;Jwa, Seung-Joo;Park, Sung Joo;Kang, Sa-Yoon
    • Annals of Clinical Neurophysiology
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    • v.19 no.1
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    • pp.54-57
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    • 2017
  • Distal acquired demyelinating symmetric (DADS) neuropathy is a variant form of chronic inflammatory demyelinating polyradiculoneuropathy. A 54-year-old man presented with gait disturbance owing to weakness in both legs. Nerve conduction studies showed demyelinating sensorimotor polyneuropathy, and laboratory studies demonstrated anti-GM1 and anti-GD1b IgG antibodies, but no anti-myelin associated glycoprotein activity. We suggest that an antiganglioside antibodies assay needs to be applied when DADS neuropathy is suspected in order to improve the classification of dysimmune neuropathies.

Colorectal carcinoma and chronic inflammatory demyelinating polyneuropathy: is there a possible paraneoplastic association?

  • Adnan Malik;Faisal Inayat;Muhammad Hassan Naeem Goraya;Gul Nawaz;Ahmad Mehran;Atif Aziz;Saad Saleem
    • Clinical Endoscopy
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    • v.56 no.2
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    • pp.245-251
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    • 2023
  • A plethora of paraneoplastic syndromes have been reported as remote effects of colorectal carcinoma (CRC). However, there is a dearth of data pertaining to the association of this cancer with demyelinating neuropathies. Herein, we describe the case of a young woman diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP). Treatment with intravenous immunoglobulins and prednisone did not improve her condition, and her neurological symptoms worsened. Subsequently, she was readmitted with exertional dyspnea, lightheadedness, malaise, and black stools. Colonoscopy revealed a necrotic mass in the ascending colon, which directly invaded the second part of the duodenum. Pathologic results confirmed the diagnosis of locally advanced CRC. Upon surgical resection of the cancer, her CIDP showed dramatic resolution without any additional therapy. Patients with CRC may develop CIDP as a type of paraneoplastic syndrome. Clinicians should remain cognizant of this potential association, as it is of paramount importance for the necessary holistic clinical management.

Chronic Inflammatory Demyelinating Polyneuropathy Presenting as Features of Guillain-Barre Syndrome (길랑-바레 증후군의 양상으로 나타난 만성염증수초탈락여러신경병증)

  • Kang, Sung-Jin;Kim, Jong Kuk;Lee, Ji-Hyun;Kim, Sang-Woo
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.70-73
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    • 2008
  • By definition, the time to reach nadir in Guillain-Barre syndrome (GBS) is within four weeks. This is in contrast to the chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), which progress for at least two months. However, CIDP can take a relapsing and remitting form and could mimic treatment related fluctuations of GBS (GBS-TRFs) especially during the early phase of disease. We report a patient with CIDP who initially presented with a rapidly progressive limb weakness mimicking GBS, but finally showed good recovery after long term corticosteroid therapy.

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A Case of IgA λ Monoclonal Gammopathy of Undetermined Significance Mimicking Acute Inflammatory Demyelinating Polyradiculoneuropathy (급성 염증성 탈수초성 다발성 신경병의 임상 양상을 보인 IgA λ형 Monoclonal Gammopathy of Undetermined Significance 1례)

  • Lee, Yeong-Bae;Jeon, Seong-Ho;Han, Dong-Chul;Shin, Dong-Jin
    • Annals of Clinical Neurophysiology
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    • v.7 no.1
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    • pp.17-19
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    • 2005
  • Polyneuropathy that is associated with monoclonal gammopathy of undetermined significance (MGUS) similar to chronic inflammatory demyelinating polyneuropathy (CIDP) has been reported before, whereas a connection to acute inflammatory demyelinating polyneuropathy (AIDP) has not been. A 52 year-old man was presented with ascending paralysis beginning 1 day ago. Neurological examinations showed facial diplegia and decreased motor power and deep tendon reflexes in all extremities. On electrophysiologic study, sensorimotor polyneuropathy was observed. Protein-and immunoelectrophoresis revealed IgA $\lambda$ monoclonal gammopathy. High dose steroid therapy was given and the symptoms improved slightly.

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Acute-onset chronic inflammatory demyelinating polyneuropathy following hepatitis A virus infection

  • Jung, Eui Sung;Kim, Ye Sel;Min, Ju-Hong;Kang, Kyusik;Lee, Jung Ju;Park, Jong-Moo;Kim, Byung-Kun;Kwon, Ohyun
    • Annals of Clinical Neurophysiology
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    • v.19 no.1
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    • pp.50-53
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    • 2017
  • An infection is less likely to elicit chronic inflammatory demyelinating polyneuropathy (CIDP) than Guillain-$Barr{\acute{e}}$ syndrome. We here report a case of acute-onset CIDP following hepatitis A virus infection and briefly comment on the potential mechanisms regarding the induction and chronicity of autoimmunity after a viral infection.

Chronic Inflammatory Demyelinating Polyneuropathy Associated with HIV-Infection (사람면역결핍바이러스 감염과 연관된 만성염증탈수초다발신경병증)

  • Huh, So-Young;Ahn, Bo-Young;Oh, Se-Jin;Park, Yeong-Eun;Kim, Dae-Seong
    • Annals of Clinical Neurophysiology
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    • v.13 no.2
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    • pp.97-100
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    • 2011
  • Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired immune-mediated polyneuropathy. Corticosteroids, intravenous immunoglobulin (IVIG) and plasmapheresis have been reported to be effective treatment. Rarely, CIDP can occur in the patients with HIV infection. The clinical features and electrophysiological findings of CIDP are known to be similar in patients with and without HIV infection. We report a 30-year-old male with HIV infection associated CIDP who improved after the administration of intravenous immunoglobulin and long term oral prednisone.