Fasial Diplejinin Eşlik Ettiği Kronik İnflamatuar Demiyelinizan Poliradikülonöropati Olgusu

Year 2016, Volume: 17 Issue: 1, 66 - 69, 01.04.2016

Serdar Oruç Hayri Demirbaş Fatıma Karakaya

Abstract

Tedavi edilebilir polinöropatilerden olan Kronik İnflamatuar Demiyelinizan Poliradikülonöropati (KİDP) bazen  hızlı progresyon  gösterebilir ve kranial sinir tutulumları da tabloya eklenebilir. Yapılan çalışmalarda bu tanı ile izlenen hastaların % 6-15’inde başta fasial sinir olmak üzere diğer  kranial sinir tutulumları saptanmıştır. Olgu sunumu yaptığımız 37 yaşındaki erkek hastada bacaklarda uyuşma ve güçsüzlük şikayetiyle başlayıp 3 yıl içinde hızlı progrese olan klinik tabloya kranial sinir tutulumlarının eklendiği saptandı. Labaratuar ve elektrofizyolojik değerlendirme ile hastaya KİDP tanısı kondu. Bu olguda KİDP hastalığının seyri sırasında kranial sinir tutulumunun da gözlenebileceği vurgulanmak istenmiştir.

Keywords

Kronik inflamatuar demiyelinizan poliradikülonöropati, Kranial sinir tutulumu, fasial dipleji

References

• Bradley WG, Daroff RB, Fenichel GM, Jankovic J (eds). Neurology in Clinical Practice Fifty Edition. Philadelphia, Pennsyvania: Butterworh Heinemann, 2008:2296-2300.
• Van der Meche FGA, Van Doorn PA. Guillain-Barre Syndrome and Chronic İnflamatory Demyelinating Polyneuropathy: Immune mechanisms and update on current therapies. Ann Neurol 1995;37:14-29.
• Lunn MPT, Manji H, Choudhary PP, et al. Chronic inflammatory demyelinating polyradiculoneuropathy: a prevalance study in South East England. J Neurol Neurosurg Psychiatry 1999;66:677-680.
• Hughes RA, Allen D, Makowska A, et al. Pathogenesis of chronic inflammatory demyelinating polyradiculoneuropathy. J. Peripher Nerv Syst 2006;11:30
• Maisonobe T, Chassande B, Verin M, Leger JM, Bouche P. Chronic dysimmune demyelinating polyneuropathy: a clinical and electrophysiological study of 93 patients. J. Neurol Neurosurg Psychiatry 1996;61:36-42.
• Midroni G. Dyck PJ. Chronic inflammatory demyelinating polyradiculoneuropathy: Unusual clinical features and therapeutic responses. Neurology 1996;46:1202-1212.
• Toyka K, Gold R. The pathogenesis of CIDP. Neurology ;60:2-7. Kusunoki S. Immuno-pathogenesis of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). Neurological Therapeutics 2004;21:675-678.
• Said G. Chronic inflammatory demyelinating polyneuropathy. Neuromuscular Disorders 2006;16:293
• Donaghy M, Early CJ. Ocular palsy preceding chronic relapsing polyneuropathy by several weeks. Ann Neurol ;17:49-50. Pieh C, Rossillion B, Heritier-Barras AC, et al. Isolated unilateral adduction deficit and ptosis as the presenting features of chronic inflammatory demyelinating polyradiculoneuropathy. J Neuroophthalmol 2002; 22: 94.
• Guibord N, Chalk C, Wein F, et al. Trigeminal nerve hypertrophy in chronic inflammatory demyelinating polyradiculoneuropathy. Neurology 1998;51:1459-1462.
• Inoue H, Tsuboi Y, Tsugawa J, et al. Hypertrophic cranial nerve roots in CIDP. Neurology 2004;63:1481.
• Barohn RJ, Kissel JT, Warmolts JR, et al. Chronic inflammatory demyelinating polyradiculoneuropathy: clinical characteristics, course, and recommendations for diagnostic criteria. Arch Neurol 1989; 46: 878-884.
• McCombe PA, Pollard JD, McLeod JG. Chronic inflammatory demyelinating polyradiculoneuropathy: a clinical and electrophysiological study of 92 cases. Brain ;110:1617-1630.
• Cruccu G, Agostino R, Inghilleri M, et al. Mandibular nerve involvement in diabetic polyneuropathy and chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 1998;21: 1673-1679.
• Kokubun N, Hirata K. Neurophysiological evaluation of trigeminal and facial nerves in patients with chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 2007;35:203-202.
• Lopate G, Pestronk A, Al-Lozi M, et al. Treatment of Chronic inflammatory demyelinating polyradiculoneuropathy with high-dose intermittent intravenous methylprednisolone, Arch Neurol ;62:249-254. Hughes R, Bensa S, Willison H. et al. Randomized controlled trial of intravenous immunoglobulin versus oral prednisolone in Chronic inflammatory demyelinating polyradiculoneuropathy, Ann Neurol 2001;50:195-201.
• Van Doorn PA, Vermeulen M, Brand A, et al. Intraveneous immunoglobulin treatment in patients with chronic inflamatory demyelinating polyneuropathy. Clinical and laboratory characteristics associated with improvement. Arch Neurol 1991;48:217-220.
• Kieseir BC, Hartung HP, Wiendl M. The inflamed peripheral nervous system: update on immune therapies, Curr Opin Neurol 2006;19:433-436.