Atypical pure sensory forms of chronic inflammatory demyelinating polyneuropathies

Abstract

Background: There are still not enough data on clinical and laboratory peculiarities of atypical chronic inflammatory demyelinating polyneuropathy (CIDP), ranging from only sensitive symptoms without weakness to asymmetric motor deficit. Recent epidemiological data do not clearly elucidate the percentage of cases with atypical CIDP from total CIDP types. Nerves conduction study, the gold standard in diagnosing demyelinating polyneuropathies has low sensibility for atypical forms of CIDP. The purpose of this study was determining the criteria for clinical and laboratory diagnosis of atypical sensory CIDP. Material and methods: Two groups of study were identified: 30 patients with typical CIDP and 30 patients with atypical CIDP. All patients underwent nerves conduction studies, blood was drawn for biochemical tests, also electrophoresis and serum protein immunofixation were done. Fibular nerve biopsy was performed in 9 patients. Overall Neuropathy Limitation Scale (ONLS) questionnaire was used for the assessment of functional disability. Results: Nerves conduction studies in cases with sensory CIDP show normal motor conduction velocity in 10 cases, and diminished only in 4 cases. Total ONLS in patients with sensory CIDP is equal to 1.85 ± 0.21 points compared to total 4.17 ± 0.240 points in patients with typical CIDP (p <0.001). Conclusions: Nerves conduction study is not a gold standard for diagnosis atypical sensory CIDP. According to functional scores results, sensory CIDP is less disabling compared with typical CIDP.