| 제목 |
Missed Diagnosis of CIDP in a Patient with Cervical Myelopathy Due to OPLL |
| 소속 |
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University1 |
| 저자 |
Dong Gyu Kwak1,1*†, Min cheol Chang1,1†, Dong Gyu Lee1,1* |
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In the current study, we report a missed diagnosis of combined chronic inflammatory demyelinating polyneuropathy (CIDP) in a patient with a cervical spinal cord lesion. At 3.5 months after the onset of symptoms, a 60-year-old female with mild motor weakness and significant weight loss underwent a surgical operation for decompression of the cervical spinal cord. However, her motor weakness was severely aggravated despite the surgical treatment, and she could not walk independently at 10 months after symptom onset. Based on the results of electrophysiological and cerebrospinal fluid tests, we diagnosed her with CIDP. Considering her medical history and the results of our evaluations, we think our patient’s neurological symptoms before the surgical operation were attributed, at least in part, to CIDP. Our study shows that clinicians should consider the possibilities of other lesions in different areas even when patients have a definite lesion in the cervical spinal cord or cervical spine. |
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Fig. 1. The sagittal CT (A) and T2-weighted cervical spine MRI (B) at 3 months after symptom onset showed ossification of the posterior longitudinal ligament at the level of C3-T1 with cervical cord compression and high signal intensity in the cervical spinal cord at the C5-6 disc space level.
Fig. 2. Median and ulnar motor nerve conduction responses at 10 months after onset showed delayed latency, decreased conduction velocity, and low amplitude of compound motor action potential. In addition, F wave on the left median nerve showed delayed latency
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