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Clinically,peripheral nerve thickening was slight or absent.Subsequently one patient developed facial nerve hypertrophy.This was mistaken for an inner ear tumor and biopsied with consequent facial palsy. Neurophysiological tests suggested a demyelinating polyneuropathy.Sural nerve biopsy showed in all cases some loss of myelinated fibers, inflammatory cell infiltration and a few onion bulbs.Hypertrophic changes were much more prominent on posterior nerve root biopsy in one patient; many fibers were surrounded by several layers of Schwann cell cytoplasm. There was an excellent response to steroids in two patients but not in the third(most advanced)patient,who has benefited only marginally from intravenous immunoglobulin therapy.MRI of the cauda equina may be a useful adjunct in the diagnosis of CIDP. |
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CAT scan,abnormal CAT scan,myelogram with cauda equina cauda equina,lesion of cranial nerve enlargement cranial nerve palsies cranial nerves facial nerve MRI MRI,abnormal MRI,cranial nerves nerve hypertrophy nerve root hypertrophy polyneuropathy,chronic inflammatory demyelinating steroid therapy,CNS treatment and complications with treatment of neurologic disorder
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