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NEUROLOGY 1996;46:1206
© 1996 American Academy of Neurology

Chronic inflammatory demyelinating polyradiculoneuropathy

Unusual clinical features and therapeutic responses

Gyl Midroni, MD and Peter James Dyck, MD

Peripheral Neuropathy Research Center, Mayo Clinic and Mayo Foundation, Rochester, MN.

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

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.

Supported in part by grants obtained from the National Institute of Neurological Disorders and Stroke (NINDS) (14304) and from the Muscular Dystrophy Association (MDA).

Received August 22, 1995. Accepted in final form October 4, 1995.




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