DefinePK

Abstract

This case report presents a 55-year-old man, with a history of hypertension, who developed an unusual and atypical presentation of chronic inflammatory demyelinating polyneuropathy (CIDP). Over 3 months, the patient experienced progressive limb weakness ascending from lower limbs to upper limbs with marked tongue fasciculations and facial muscle weakness without dysarthria or dysphagia. While cranial nerve involvement has been documented in CIDP, cases featuring the hypoglossal nerve are much less frequent than those with the facial nerve. This makes the occurrence of both happening at the same time quite rare. Diagnosing atypical presentations of CIDP can be tricky, and offer a challenge for neurologists in daily practice. A comprehensive diagnostic workup that could include blood work, cerebrospinal fluid analysis, and a nerve conduction study is required to confirm the diagnosis and rule out potential other causes. Effective management in this case included several inpatient plasmapheresis sessions and administration of steroids, which led to significant clinical improvement in the patient’s symptoms. These breakthroughs are essential for clinicians to promptly diagnose and treat patients suffering from the same diseases.