Case 22
History:
55 year old male with history of lymphoma presenting with right lower extremity paresthesia.
Findings:
Post gadolinum MR imaging showing a thickened enhancing left L5 nerve root.
Diagnosis:
Discussion:
Chronic inflammatory demyelinating polyneuropathy (CIDP) is characterized by progressive weakness and impaired sensory function in the lower and upper extremities. It is more common in young adults, and in men more so than women. It is presumed to be an immunologic antibody-mediated reaction resulting in a segmental demyelination of peripheral nerves. Most frequently idiopathic, but has been known to occur with several conditions such as systemic lupus erythematosus, Hodgkin lymphoma, multiple eclerosis, inflammatory bowel disease, Chronic active hepatitis, Paraproteinemias and/or plasma cell dyscrasias, HIV infection. Pregnancy may exacerbate the disease. MRI may show abnormal enhancement and/or enlargement of affected nerve roots. Treatment for CIDP includes corticosteroids such as prednisone, which may be prescribed alone or in combination with immunosuppressant.
