Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1990 Sep;53(9):789–793. doi: 10.1136/jnnp.53.9.789

Involvement of the central nervous system in chronic inflammatory demyelinating polyneuropathy: a clinical, electrophysiological and magnetic resonance imaging study.

I E Ormerod 1, H M Waddy 1, A G Kermode 1, N M Murray 1, P K Thomas 1
PMCID: PMC1014259  PMID: 2174078

Abstract

In a consecutive series of 30 patients with chronic inflammatory demyelinating polyneuropathy (CIDP) minor clinical evidence of CNS involvement was found in five. Cranial magnetic resonance imaging (MRI) was performed in 28 and revealed abnormalities consistent with demyelination in nine patients aged less than 50 years and abnormalities in five aged 50 years or over. Measurements of central motor conduction time (CMCT) were obtained in 18 and showed unilateral or bilateral abnormalities in six. It is concluded that subclinical evidence of central nervous system (CNS) involvement is common, at least in patients with CIDP in the United Kingdom, but that clinically evident signs of CNS disease are infrequent. The association of a multiple sclerosis-like syndrome with CIDP is rare.

Full text

PDF
789

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. AUSTIN J. H. Recurrent polyneuropathies and their corticosteroid treatment; with five-year observations of a placebo-controlled case treated with corticotrophin, cortisone, and prednisone. Brain. 1958 Jun;81(2):157–192. doi: 10.1093/brain/81.2.157. [DOI] [PubMed] [Google Scholar]
  2. Barohn R. J., Kissel J. T., Warmolts J. R., Mendell J. R. Chronic inflammatory demyelinating polyradiculoneuropathy. Clinical characteristics, course, and recommendations for diagnostic criteria. Arch Neurol. 1989 Aug;46(8):878–884. doi: 10.1001/archneur.1989.00520440064022. [DOI] [PubMed] [Google Scholar]
  3. Dyck P. J., Lais A. C., Ohta M., Bastron J. A., Okazaki H., Groover R. V. Chronic inflammatory polyradiculoneuropathy. Mayo Clin Proc. 1975 Nov;50(11):621–637. [PubMed] [Google Scholar]
  4. Feeney D. J., Pollard J. D., McLeod J. G., Stewart G. J., Doran T. J. HLA antigens in chronic inflammatory demyelinating polyneuropathy. J Neurol Neurosurg Psychiatry. 1990 Feb;53(2):170–172. doi: 10.1136/jnnp.53.2.170. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Gigli G. L., Carlesimo A., Valente M., Mazza S., Di Trapani G., Hernandez R., Tomassetti P. Evoked potentials suggest cranial nerves and CNS involvement in chronic relapsing polyradiculoneuropathy. Eur Neurol. 1989;29(3):145–149. doi: 10.1159/000116398. [DOI] [PubMed] [Google Scholar]
  6. Hess C. W., Mills K. R., Murray N. M., Schriefer T. N. Magnetic brain stimulation: central motor conduction studies in multiple sclerosis. Ann Neurol. 1987 Dec;22(6):744–752. doi: 10.1002/ana.410220611. [DOI] [PubMed] [Google Scholar]
  7. Ketelaer C. J., Leruitte A., Perier O. Histopathologie de la moelle lombo-sacree et de la queue de cheval dans une serie de cas verifies de sclerose en plaques. Expose des faits anatomo-cliniques et de la semiologie urinaire. Acta Neurol Scand. 1966;42(Suppl):33–51. [PubMed] [Google Scholar]
  8. Lassmann H., Budka H., Schnaberth G. Inflammatory demyelinating polyradiculitis in a patient with multiple sclerosis. Arch Neurol. 1981 Feb;38(2):99–102. doi: 10.1001/archneur.1981.00510020057008. [DOI] [PubMed] [Google Scholar]
  9. McCombe P. A., Pollard J. D., McLeod J. G. Chronic inflammatory demyelinating polyradiculoneuropathy. A clinical and electrophysiological study of 92 cases. Brain. 1987 Dec;110(Pt 6):1617–1630. doi: 10.1093/brain/110.6.1617. [DOI] [PubMed] [Google Scholar]
  10. McDonald W. I. Multiple sclerosis: epidemiology and HLA associations. Ann N Y Acad Sci. 1984;436:109–117. doi: 10.1111/j.1749-6632.1984.tb14781.x. [DOI] [PubMed] [Google Scholar]
  11. Mendell J. R., Kolkin S., Kissel J. T., Weiss K. L., Chakeres D. W., Rammohan K. W. Evidence for central nervous system demyelination in chronic inflammatory demyelinating polyradiculoneuropathy. Neurology. 1987 Aug;37(8):1291–1294. doi: 10.1212/wnl.37.8.1291. [DOI] [PubMed] [Google Scholar]
  12. Miller D. H., Rudge P., Johnson G., Kendall B. E., Macmanus D. G., Moseley I. F., Barnes D., McDonald W. I. Serial gadolinium enhanced magnetic resonance imaging in multiple sclerosis. Brain. 1988 Aug;111(Pt 4):927–939. doi: 10.1093/brain/111.4.927. [DOI] [PubMed] [Google Scholar]
  13. Mills K. R., Murray N. M. Electrical stimulation over the human vertebral column: which neural elements are excited? Electroencephalogr Clin Neurophysiol. 1986 Jun;63(6):582–589. doi: 10.1016/0013-4694(86)90145-8. [DOI] [PubMed] [Google Scholar]
  14. Ninfo V., Rizzuto N., Terzian H. Associazione anatomo-clinica di nevrite ipertrofica e sclerosi a placche. Acta Neurol (Napoli) 1967 Mar-Apr;22(2):228–237. [PubMed] [Google Scholar]
  15. Ormerod I. E., Miller D. H., McDonald W. I., du Boulay E. P., Rudge P., Kendall B. E., Moseley I. F., Johnson G., Tofts P. S., Halliday A. M. The role of NMR imaging in the assessment of multiple sclerosis and isolated neurological lesions. A quantitative study. Brain. 1987 Dec;110(Pt 6):1579–1616. doi: 10.1093/brain/110.6.1579. [DOI] [PubMed] [Google Scholar]
  16. Pakalnis A., Drake M. E., Jr, Barohn R. J., Chakeres D. W., Mendell J. R. Evoked potentials in chronic inflammatory demyelinating polyneuropathy. Arch Neurol. 1988 Sep;45(9):1014–1016. doi: 10.1001/archneur.1988.00520330104017. [DOI] [PubMed] [Google Scholar]
  17. Ro Y. I., Alexander C. B., Oh S. J. Multiple sclerosis and hypertrophic demyelinating peripheral neuropathy. Muscle Nerve. 1983 May;6(4):312–316. doi: 10.1002/mus.880060411. [DOI] [PubMed] [Google Scholar]
  18. Rosenberg N. L., Bourdette D. Hypertrophic neuropathy and multiple sclerosis. Neurology. 1983 Oct;33(10):1361–1364. doi: 10.1212/wnl.33.10.1361. [DOI] [PubMed] [Google Scholar]
  19. Rubin M., Karpati G., Carpenter S. Combined central and peripheral myelinopathy. Neurology. 1987 Aug;37(8):1287–1290. doi: 10.1212/wnl.37.8.1287. [DOI] [PubMed] [Google Scholar]
  20. Schoene W. C., Carpenter S., Behan P. O., Geschwind N. 'Onion bulb' formations in the central and peripheral nervous system in association with multiple sclerosis and hypertrophic polyneuropathy. Brain. 1977 Dec;100(4):755–773. doi: 10.1093/brain/100.4.755. [DOI] [PubMed] [Google Scholar]
  21. Thomas P. K., Lascelles R. G., Hallpike J. F., Hewer R. L. Recurrent and chronic relapsing Guillain-Barré polyneuritis. Brain. 1969;92(3):589–606. doi: 10.1093/brain/92.3.589. [DOI] [PubMed] [Google Scholar]
  22. Thomas P. K., Walker R. W., Rudge P., Morgan-Hughes J. A., King R. H., Jacobs J. M., Mills K. R., Ormerod I. E., Murray N. M., McDonald W. I. Chronic demyelinating peripheral neuropathy associated with multifocal central nervous system demyelination. Brain. 1987 Feb;110(Pt 1):53–76. doi: 10.1093/brain/110.1.53. [DOI] [PubMed] [Google Scholar]
  23. Waddy H. M., Misra V. P., King R. H., Thomas P. K., Middleton L., Ormerod I. E. Focal cranial nerve involvement in chronic inflammatory demyelinating polyneuropathy: clinical and MRI evidence of peripheral and central lesions. J Neurol. 1989 Oct;236(7):400–405. doi: 10.1007/BF00314898. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES