Short Reports

We wish to report a case of CIDP in association with seminoma. A 43-year-old man without significant past medical history developed bilateral lower extremity more than upper extremity weakness about 6 months before presentation. Examination was significant for severe weakness (Medical Research Council, MRC, grade 0–1) of the foot and toe extensors and flexors, moderate weakness of the intrinsic hand muscles (MRC grade 3), mild weakness of proximal lower extremity muscles (MRC grade 4–5) and a steppage gait. Reflexes were hypoactive to absent, and perception of vibration and position sensations were reduced in the distal lower extremities. Laboratory testing included negative tests for HIV-1 and Borrelia burgdorferi infections, absence of monoclonal gammopathy on immunoelectrophoresis, negative antimyelin-associated glycoprotein antibody, and a cerebrospinal fluid (CSF) protein of 267 mg/dl (normal range 15– 45) with no cells and negative VDRL. Nerve conduction studies are shown in figure 1a. The electromyographic (EMG) needle examination showed scant fibrillations and positive sharp waves and diffusely reduced motor unit action potential recruitment in all muscles exam