Chronic immune sensorimotor polyradiculopathy: Report of a case series

Abstract

Introduction Chronic immune sensorimotor polyradiculopathy (CISMP) is a chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) variant affecting both sensory and motor nerve roots without evidence of peripheral nerve demyelination. Methods We report a case series of 9 patients with CISMP, identified from 2 tertiary centers. Clinical, electrodiagnostic, and neuroradiologic features, and treatment responses, were retrospectively reviewed. Results Patients presented with sensorimotor deficits and hypo‐/areflexia, predominantly involving lower extremities. Three had cranial nerve involvement. Electrodiagnostic findings in all patients localized to roots proximal to dorsal root ganglia, without evidence of peripheral nerve demyelination. Cerebrospinal fluid examination revealed an albuminocytologic association. Eight patients exhibited gadolinium enhancement and thickening of multiple spinal nerve roots and/or cranial nerves. All patients demonstrated good responses to immunotherapies. Discussion CISMP is similar to CIDP in many aspects, but lacks typical electrodiagnostic findings of peripheral nerve demyelination. It is important to recognize this unusual and treatable entity. Muscle Nerve 59:658–664, 2019

Daily grip strength response to intravenous immunoglobulin in chronic immune neuropathies

“…The Inflammatory Rasch-built Overall Disability Scale (I-RODS) for CIDP patients and the MMN-RODS for MMN patients were chosen as disease-specific outcome measures to assess disability. 19,20 We defined clinically important change in disability as at least 4 centile points on the inflammatory RODS score for CIDP or chronic immune sensorimotor polyradiculopathy (CISMP), 21 or at least 4 raw points on the MMN-RODS for MMN (as the centile transformation is not published).…”

“…criteria for CISMP variant of CIDP but not for CIDP) 21. All eligible patients had reduced GS in at least one hand compared with normal reference values 12.…”

Early Aggressive Immunotherapy Improves Functional Outcome in Chronic Immune Sensory Polyradiculopathy

“…Neurologic examination indicates large-fibre sensory loss and sensory gait ataxia. Muscle strength is often preserved except in CISMP where there is concomitant motor nerve root involvement [2][3][4][5].…”

“…ough some patients may have concomitant involvement of the proximal motor nerve roots and are termed chronic immune sensorimotor polyradiculopathy (CISMP) [2][3][4][5], others have disease strictly confined to the proximal sensory nerve roots. Publications related to CISP [6][7][8] remain rare and limited since the entity was first described.…”

Expanding the spectrum of immune mediated peripheral nerve disorders

“…In this issue of Muscle and Nerve , Thammongkolchai et al bring to light another disorder that is amenable to treatment. They report a series of 9 patients with a chronically progressive inflammatory sensory and motor polyradiculopathy (CISMP) without evidence of peripheral nerve involvement distal to the nerve roots.…”