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Chronic inflammatory demyelinating polyneuropathy, phrenic nerve and respiratory symptoms
Author(s) -
Costa J.,
Carvalho M.
Publication year - 2005
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2004.00961.x
Subject(s) - medicine , chronic inflammatory demyelinating polyneuropathy , phrenic nerve , diaphragm (acoustics) , respiratory system , electromyography , motor nerve , anesthesia , guillain barre syndrome , polyneuropathy , physical medicine and rehabilitation , surgery , anatomy , pediatrics , physics , antibody , acoustics , loudspeaker , immunology
Respiratory involvement in chronic inflammatory demyelinating polyneuropathy (CIDP) has been very recently described. Phrenic nerve conduction studies have been described as useful to detect respiratory impairment in these patients. This study describes two patients with CIDP, in whom neurophysiological studies of the respiratory muscles were performed. The first patient had severe respiratory insufficiency, and phrenic nerve studies disclosed no motor responses and electromyography (EMG) of the diaphragm confirmed severe loss of motor units, bilaterally. On treatment, we documented clinical and neurophysiological improvement. In the second patient, phrenic nerve studies showed abnormal results; however, EMG of the diaphragm ruled out loss of motor units. The first case represents the risk of phrenic nerve involvement in this disorder, and the potential recovery on treatment. The second case illustrates that the temporal dispersion of the motor responses can be misleading, and EMG of diaphragm should be performed to confirm the loss of motor units.