CIDP PRESENTING AS MYELORADICULOPATHY

Abstract

Chronic inammatory demyelinating polyradiculoneuropathy (CIDP) is a relapsing or chronic progressive disorder which is one of the causes of hypertrophic neuropathy. Enlarged nerve roots were identied in few patients. We now report a case of CIDP with highly thickened or enlarged nerve roots severe enough to cause cord compression and myelopathy. A 38 year old woman presented with weakness and sensory disturbances in lower limbs with sensory level at L1 and bladder disturbances in form of urgency and urge incontinence . MRI showed a non enhancing isointense mass lesion from L1 to S1 causing compression over conus . During surgery the cauda equina nerve roots were found to be thickened , entangled with ' bag of worms' appearance. Nerve conduction studies showed all her peripheral nerves to be inexcitable. Her CSF protein was mildly elevated. Diagnosis of CIDP with thickened nerve roots was considered and she was started on steroids and subsequently showed improvement. Thus, CIDP may present with symptoms of myeloradiculopathy due to thickened nerve roots causing cord compression.