Neurology: Case of the Month

Test Yourself — Patient 15

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

  1. All of the following symptoms/signs are commonly seen in a patient with CIDP, EXCEPT:
    • [ A ] Painful paresthesias
    • [ B ] Numbness and tingling
    • [ C ] Muscle weakness, legs affected more than arms
    • [ D ] Absent or depressed reflexes
  2. The following statement is TRUE regarding CIDP:
    • [ A ] Represents one-third of all initially undiagnosed acquired neuropathies.
    • [ B ] The peak incidence is 60 to 69 years of age.
    • [ C ] Patients usually have spontaneous remission and rarely have prolonged neurological disability.
    • [ D ] Twenty-five percent of patients will show initial improvement following immunosuppressive therapy.
  3. Typical CSF findings in CIDP include all of the following, EXCEPT:
    • [ A ] Elevated CSF protein
    • [ B ] Elevated Q-albumin
    • [ C ] Elevated IgG index and IgG synthesis rate
    • [ D ] CSF pleocytosis
  4. The following statement is TRUE regarding CIDP:
    • [ A ] Neck extensor weakness commonly seen in CIDP patients helps to distinguish it from most other neuropathies.
    • [ B ] Sensory findings are severe but rarely include impaired touch or vibratory sensation.
    • [ C ] Neurologic exam may reveal proximal weakness, sometimes even more affected than distal musculature.
    • [ D ] Cranial nerve involvement is commonly seen, especially cranial nerves III, IV, and VI.
  5. All of the following are CORRECT regarding CIDP, EXCEPT:
    • [ A ] The EMG/NCV in a patient with typical CIDP usually helps to confirm demyelination as the predominant process.
    • [ B ] Impairment of the blood brain barrier most likely occurs at the level of the inflamed nerve root sheaths within the thecal sac.
    • [ C ] Beta interferon has been reported to have a possible benefit in the treatment of CIDP.
    • [ D ] Nerve biopsy has been reported to reveal demyelination in 48 percent of CIDP patients.

 

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