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Washington University Experience | PERIPHERAL NEUROPATHY | 7B CIDP | 13A0 Case 13 History
Case 13 History ---- The patient is a 58-year-old female with a (>7 year) history of asymmetric, slowly ascending weakness, followed by slowly ascending numbness. Electromyography and nerve conduction studies in 2014 showed electrodiagnostic evidence of a primary demyelinating sensory motor polyneuropathy. More recently, she reported atrophy of the left quadriceps muscle, improvement of left hip pain with IVIG therapy, persistent and stable hand weakness, and nocturnal-predominant muscle spasms over the hands, legs, and face. Physical examination was notable for some dysmorphic features and significant wasting of pectoralis and shoulder girdle muscles, with some scapular winging as well as asymmetric pes cavus and hammertoes. Her most recent electromyography and nerve conduction studies again showed electrodiagnostic evidence of a primary demyelinating sensory motor polyneuropathy, with minimal evidence of progression. Per a neuromuscular Division note, the clinical impression favors chronic demyelinating polyneuropathy (CIDP), with some concern for a hereditary polyneuropathy of unclear type (despite EMG/NCS findings suggestive of an acquired (non-hereditary) process). Operative procedure: Left wrist muscle and left wrist nerve biopsies.
