scholarly journals Chronic Inflammatory Demyelinating Polyradiculopathy with Multiple Cranial Nerve Palsy: An Atypical Pediatric Case

2020 ◽  
Vol 6 (1) ◽  
pp. 64-66
Author(s):  
Husnea Ara Khan ◽  
Nusrat Shams ◽  
Narayan Saha ◽  
Dipa Saha ◽  
Jobaida Parveen ◽  
...  
Keyword(s):  
Nerve Palsy ◽  
Early Recognition ◽  
Chronic Inflammatory Demyelinating Polyradiculoneuropathy ◽  
Diagnostic Challenge ◽  
Pediatric Case ◽  
Diagnostic Difficulties ◽  
Multiple Cranial Nerve Palsy ◽  
Treatable Condition ◽  
Chronic Inflammatory Demyelinating Polyradiculopathy ◽  
Progressive Course

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is relatively rare in children. Moreover, atypical presentation remains a diagnostic challenge for physician. Early recognition and proper immunomodulatory therapy is important for favorable outcomes with prevention of progressive course. We report a case with atypical CIDP. The aim was to focus on the diagnostic difficulties and the importance of recognizing this treatable condition. Journal of National Institute of Neurosciences Bangladesh, 2020;6(1): 64-66

scholarly journals Chronic Inflammatory Demyelinating Polyradiculoneuropathy 101—Pitfalls and Pearls of Diagnosis and Treatment

US Neurology ◽  
2017 ◽  
Vol 13 (01) ◽  
pp. 18 ◽  
Author(s):  
Said R Beydoun ◽  
Thomas H Brannagan III ◽  
Peter Donofrio ◽  
Carol Lee Koski ◽  
Eric Lancaster ◽  
...  
Keyword(s):  
Peripheral Nerves ◽  
Ivig Therapy ◽  
Chronic Inflammatory Demyelinating Polyradiculoneuropathy ◽  
Sensory Function ◽  
Therapeutic Interventions ◽  
First Line ◽  
Chronic Disability ◽  
Treatable Condition ◽  
Progressive Weakness

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), which is caused by demyelination of the peripheral nerves, is characterized by progressive weakness and impaired sensory function in the arms and legs. CIDP is a treatable condition in which early diagnosis is crucial to limit chronic disability. CIDP can mimic other neuropathies and it is important to identify these in order to ensure prompt treatment. Patients with other causes of neuropathy should be suspected of having CIDP if there is rapid progress or proximal weakness. Intravenous immunoglobulin (IVIG), corticosteroids, and plasma exchange are first-line therapies. The IVIG CIDP Efficacy (ICE) trial, the largest trial reported of any CIDP treatment, demonstrated that IVIG therapy reduced disability and functional impairment, as well as improved quality of life. Autoantibodies against membrane proteins of the peripheral nerve axons or the myelin sheath have been reported recently, and an improved understanding of antibody responses in CIDP may enable the development of future targeted therapeutic interventions.

scholarly journals A rare case of tuberculoma masquerading as CP Angle neoplasm

2019 ◽  
Vol 10 (4) ◽  
pp. 73-75
Author(s):  
Sinjan Ghosh ◽  
Gautam Guha ◽  
Kaushik Roy ◽  
Annesh Bhattacharjee ◽  
Nikhil Repaka ◽  
...  
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Cerebellopontine Angle ◽  
Rare Case ◽  
Nerve Palsy ◽  
Neoplastic Lesion ◽  
Neoplastic Lesions ◽  
Significant Clinical Improvement ◽  
Multiple Cranial Nerve Palsy ◽  
Multiple Cranial Nerve

Tuberculoma involving the cerebellopontine angle is very rare. Preoperative neuroradiological features of such lesions may mimic neoplastic lesions. Our case presented with cerebellar features and multiple cranial nerve palsy. Neuroimaging mimicked CP angle neoplastic lesion. Antitubercular therapy and steroids resulted in significant clinical improvement and marked radiological reduction in size of the lesion. In our subcontinent a treatable infective cause like tuberculosis should be ruled out in CP angle lesions. Although rare but definitely a possibility to be considered.

scholarly journals Bilateral Facial Nerve Palsy: A Diagnostic Dilemma

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sohil Pothiawala ◽  
Fatimah Lateef
Keyword(s):  
Differential Diagnosis ◽  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Rare Condition ◽  
Facial Nerve Paralysis ◽  
Diagnostic Challenge ◽  
Radiological Investigation ◽  
Diagnostic Dilemma ◽  
Nerve Paralysis

Introduction. Bilateral facial nerve palsy (FNP) is a rare condition, representing less than 2% of all cases of FNP. Majority of these patients have underlying medical conditions, ranging from neurologic, infectious, neoplastic, traumatic, or metabolic disorders.Objective. The differential diagnosis of its causes is extensive and hence can present as a diagnostic challenge. Emergency physicians should be aware of these various diagnostic possibilities, some of which are potentially fatal.Case Report. We report a case of a 43-year-old female who presented to the emergency department with sequential bilateral facial nerve paralysis which could not be attributed to any particular etiology and, hence, presented a diagnostic dilemma.Conclusion. We reinforce the importance of considering the range of differential diagnosis in all cases presenting with bilateral FNP. These patients warrant admission and prompt laboratory and radiological investigation for evaluation of the underlying cause and specific further management as relevant.

Rapidly progressive course of very late onset multiple sclerosis presenting with Parkinsonism: case report

2010 ◽  
Vol 17 (2) ◽  
pp. 245-249 ◽  
Author(s):  
T Schultheiss ◽  
H Reichmann ◽  
T Ziemssen
Keyword(s):  
Multiple Sclerosis ◽  
Potential Benefit ◽  
Late Onset ◽  
Age Groups ◽  
Treatment Strategies ◽  
Disease Course ◽  
Spastic Paraplegia ◽  
Diagnostic Challenge ◽  
Progressive Course ◽  
Neuroprotective Therapies

Multiple sclerosis mainly affects young adolescents, making late-onset multiple sclerosis a rarity and diagnostic challenge, particularly for cases after age 80 years. We present an 82-year-old patient with multiple sclerosis with very late onset. As well as spastic paraplegia, additional Parkinsonism secondary to demyelination in the basal ganglia was observed in this case. In most publications, spinal cord lesions were more common in late-onset multiple sclerosis which, in contrast, could not be found in our case. Despite different treatment strategies, rapid clinical deterioration and death after about 2 years of disease course occurred. Further discrimination in late-onset multiple sclerosis (50–70 years) and multiple sclerosis with very late onset (above 70 years) might be considered. Future trials to elucidate potential benefit of immunosuppressive (and neuroprotective) therapies in these age groups are mandatory.

scholarly journals A 7-Year History of Necrobiotic Xanthogranuloma following Asymptomatic Multiple Myeloma: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Siriluk Inthasotti ◽  
Rungsima Wanitphakdeedecha ◽  
Jane Manonukul
Keyword(s):  
Multiple Myeloma ◽  
Case Report ◽  
Monoclonal Gammopathy ◽  
Early Recognition ◽  
Strong Association ◽  
Hematologic Malignancies ◽  
Morbidity And Mortality ◽  
Wound Complications ◽  
History Of ◽  
Progressive Course

Necrobiotic xanthogranuloma (NXG) is a rare destructive xanthomatous granuloma with chronic, indolent, and progressive course. The morbidity and mortality are the results from wound complications and associated disorders. Because of its strong association with monoclonal gammopathy and multiple myeloma, early recognition of disease is mandatory to monitor and prevent systemic involvements of hematologic malignancies.

scholarly journals Lupus Nephritis in a Patient with Sickle Cell Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Vinay Minocha ◽  
Fauzia Rana
Keyword(s):  
Sickle Cell Disease ◽  
Lupus Nephritis ◽  
Renal Biopsy ◽  
Sickle Cell ◽  
Lupus Erythematosus ◽  
Early Recognition ◽  
African American Female ◽  
Cell Disease ◽  
Diagnostic Challenge ◽  
Renal Abnormality

Introduction. The diagnosis of systemic lupus erythematosus (SLE) in patients with sickle cell disease (SCD) can be difficult to establish because the musculoskeletal, central nervous system, and renal manifestations are similar in both diseases. In the presented case, we highlight the diagnostic challenge that can evolve in patients with a concurrence of both diseases and we establish the importance of early recognition and treatment of lupus nephritis in patients with SCD.Case Presentation. We present a case of a 31-year-old African American female with sickle-C disease (hemoglobin SC) who was admitted to our hospital with complaints of periumbilical abdominal pain associated with intractable nausea and vomiting, abdominal distension, and worsening lower extremity edema. Urine studies revealed nephrotic range proteinuria and the immunological investigations were consistent with lupus. A renal biopsy revealed focal proliferative lupus nephritis.Conclusion. It is important to consider the presence of a coexisting autoimmune disease in a patient with sickle hemoglobinopathy who displays an atypical and multisystem presentation that is unresponsive to conventional therapies. When a significant kidney disease is present, a renal biopsy is critical in identifying the etiology of a renal abnormality in the setting of coexisting SLE and SCD.

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