Chronic inflammatory demyelinating polyneuropathy of childhood: clinical and neuroradiological findings

Neuroradiology. 2013 Oct;55(10):1233-9. doi: 10.1007/s00234-013-1240-z. Epub 2013 Jul 27.

Abstract

Introduction: This study aims to report on serial magnetic resonance imaging (MRI) studies and clinical features in a cohort of children with chronic inflammatory demyelinating polyneuropathy (CIDP).

Methods: Clinical, neuroradiological, and statistical investigations performed on nine children with CIDP were retrospectively reviewed. Pathological nerve root enhancement was categorized according to severity, extension, and morphology. A MRI score was thus obtained, and correlations with the clinical picture and disease course were explored.

Results: Intrathecal nerve root enhancement (NRE) of varying degrees was seen in a high percentage of patients. There was no significant correlation between the total MRI score at the first MRI study and either severity or course of the disease. However, we found a significant difference (p = 0.002) in NRE of patients with improving CIDP with respect to those with stable or progressing disease at the time of follow-up MRI.

Conclusion: Contrast-enhanced MRI plays a pivotal role in children with CIDP, both for the initial diagnosis as well as a biomarker of clinical evolution, and should be performed in all children with suspected CIDP both at initial presentation and during follow-up. Further multicenter studies on larger cohorts are awaited to determine the ideal timing for follow-up MRI.

MeSH terms

  • Adolescent
  • Algorithms*
  • Child
  • Child, Preschool
  • Contrast Media
  • Female
  • Gadolinium*
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / pathology*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Spinal Nerve Roots / pathology*

Substances

  • Contrast Media
  • Gadolinium