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Chronic immune sensory polyradiculopathy (CISP): First juvenile case description.
Neurological Sciences ( IF 3.3 ) Pub Date : 2020-07-10 , DOI: 10.1007/s10072-020-04588-y
Stefano Sotgiu 1 , A Minutolo 1 , A Carta 1 , G Puseddu 1 , P E Doneddu 2 , E Nobile-Orazio 2
Affiliation  

In its typical presentation, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) occurs more often in old males as a progressive/recurrent motor and sensory nerve dysfunction with tendon areflexia. However, CIDP has also atypical clinical presentations, including pure sensory neuropathies, among which chronic immune sensory polyradiculopathy (CISP) accounts for only 0.5% of all CIDP, with no juvenile cases reported as yet. A 17-year-old girl presented for a progressive sensory ataxia and hands clumsiness. Diffuse tendon areflexia and hypokinaesthesia were observed. Motor and sensory nerve conduction studies were normal. F-waves were normal in median nerves and elongated in tibial nerves. H-reflex and somatosensory evoked potentials (SSEP) were absent. CSF normal cellularity with hyperproteinorrachia was found. Paraneoplastic, metabolic, and paraproteinemic neuropathies were excluded. A diagnosis of CISP has been made based on the presence of pure sensory symptoms in a polyneuropathic distribution, normal peripheral nerve conduction studies, and two supportive criteria (SSEP and CSF). Our paper describes the first CISP case in the pediatric age. We confirm SSEP and CSF as useful complementary tests for this diagnosis also at this age and suggest that clinicians should consider CISP in the spectrum of sporadic sensory ataxias of the pediatric age. We also suggest that in the presence of normal F-wave and peripheral motor nerve conduction, an absent H-reflex can further substantiate SSEPs in the diagnosis of CISP. Intravenous immunoglobulins were rapidly effective and safe.



中文翻译:

慢性免疫感觉多发性神经根病(CISP):第一个青少年病例描述。

在其典型表现中,慢性炎症性脱髓鞘性多发性神经根神经病(CIDP)在老年男性中更常见,是进行性/复发性运动和肌腱反射性感觉神经功能障碍。但是,CIDP也有非典型的临床表现,包括单纯的感觉神经病,其中慢性免疫感觉多发性神经根病(CISP)仅占全部CIDP的0.5%,目前尚无少年病例报告。一名17岁女孩因进行性感觉共济失调和手笨拙而出现。观察到弥漫性肌腱反射不良和运动感觉减退。运动和感觉神经传导研究正常。F波在正中神经中正常,在胫神经中拉长。缺少H反射和体感诱发电位(SSEP)。发现脑脊液细胞正常,伴蛋白过多症。副肿瘤 排除了代谢性和副蛋白血症性神经病。基于多神经性分布中的纯感觉症状,正常的周围神经传导研究和两个支持标准(SSEP和CSF),已经做出了CISP的诊断。我们的论文描述了儿科时代的第一例CISP病例。我们确认SSEP和CSF在这个年龄也可以作为对该诊断的有用补充测试,建议临床医生应在儿童年龄的偶发性感觉性共济失调方面考虑使用CISP。我们还建议,在正常F波和周围运动神经传导存在的情况下,缺乏H反射可以进一步证实SSEP​​在CISP的诊断中。静脉注射免疫球蛋白迅速有效且安全。基于多神经性分布中的纯感觉症状,正常的周围神经传导研究和两个支持标准(SSEP和CSF),已经做出了CISP的诊断。我们的论文描述了儿童时代的第一例CISP病例。我们证实SSEP​​和CSF在这个年龄也可以作为对该诊断的有用补充测试,建议临床医生应在儿童年龄的偶发性感觉性共济失调方面考虑CISP。我们还建议,在正常F波和周围运动神经传导存在的情况下,缺乏H反射可以进一步证实SSEP​​在CISP的诊断中。静脉注射免疫球蛋白迅速有效且安全。基于多神经性分布中的纯感觉症状,正常的周围神经传导研究和两个支持标准(SSEP和CSF),已经做出了CISP的诊断。我们的论文描述了儿科时代的第一例CISP病例。我们确认SSEP和CSF在这个年龄也可以作为对该诊断的有用补充测试,建议临床医生应在儿童年龄的偶发性感觉性共济失调方面考虑使用CISP。我们还建议,在正常F波和周围运动神经传导存在的情况下,缺乏H反射可以进一步证实SSEP​​s在CISP的诊断中。静脉注射免疫球蛋白迅速有效且安全。我们的论文描述了儿科时代的第一例CISP病例。我们确认SSEP和CSF在这个年龄也可以作为对该诊断的有用补充测试,建议临床医生应在儿童年龄的偶发性感觉性共济失调方面考虑使用CISP。我们还建议,在正常F波和周围运动神经传导存在的情况下,缺乏H反射可以进一步证实SSEP​​在CISP的诊断中。静脉注射免疫球蛋白迅速有效且安全。我们的论文描述了儿科时代的第一例CISP病例。我们证实SSEP​​和CSF在这个年龄也可以作为对该诊断的有用补充测试,建议临床医生应在儿童年龄的偶发性感觉性共济失调方面考虑CISP。我们还建议,在正常F波和周围运动神经传导存在的情况下,缺乏H反射可以进一步证实SSEP​​在CISP的诊断中。静脉注射免疫球蛋白迅速有效且安全。缺乏H反射可进一步证实SSEP​​在CISP的诊断中。静脉注射免疫球蛋白迅速有效且安全。缺乏H反射可进一步证实SSEP​​在CISP的诊断中。静脉注射免疫球蛋白迅速有效且安全。

更新日期:2020-07-10
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