1 case of chronic inflammatory demyelinion-prone neuroroot neuropathy.

!---- male, 19 years oldwas admitted to hospital for "facial numbness, numbness in the limbs and inability to engage in sexual aggravation for more than 1 year"admission 15 months before no obvious cause of coughing, no fever, and then gradually appear edire numbness of the two sides and foot bottom, the back neck and waist discomfort, numbness of the hands and fingertips, about 4 months after no obvious cause of nausea, vomitingthe local hospital cerebrospinal fluid conventional display protein-cell separation: white blood cells (-), protein 152mg/dl (normal value 15 to 45 mg/dl);give C-type globulin static drops, A strong dragon oral treatment, the patient's face and hands tip numbness improved, but still feel numb foot, walking unstable, so to my hospitaladmission: bi-calf muscle atrophy, bipedal flexion and back flex IV grade, bi-toe back extension and flex II grade, double lower limb shallow and deep feeling loss, left knee reflection and ankle reflection disappear, right knee reflex, ankle reflex disappear, two-sided pathological signs (-), gait co-generation disorder, Romberg tendon (and double-leg tendon;laboratory examination: vitamin B12 increase 1112pg/ml (normal value 180 to 914pg/ml), considering the oral methylcobalamin associated with: cerebrospinal immunoglobulin increase: IgA1.16mg/dl (normal value 0.0 to 0.2 pg/ml), IgM0.41mg/dl (normal value 0.0-0.0.0.0.0.0.0.0.dl), Ig1.0.0.0.dlGGGG 13.50mg/dl (normal value 0.48 to 5.86mg/dl); total hydrospinal cells increased by 14 x 106/L (normal value 0.0 to 8.0 x 106/L), white blood cell count increased by 14 x 106/L, and cerebrospinal fluid protein increased by 164mg/dl (normal value 15 to 45 mg/dl)electromyography test showed that the surrounding sexual damage of the limbs (feeling, motor fibers are affected)left phytoplasmic biopsy pathology showed: mild thickening of the nerve beam membrane, interstitial edema of nerve fibers, myelin and axial rope did not see a clear loss;lumbar vertebral MR examination: flat sweep sacroon T2WI (Figure 1A), T1WI (Figure 1B), nerve root imaging (Figure 1C) showed that the nerve roots on both sides of the lumbar 2-2 were significantly thickened;clinically diagnosed as chronic inflammatory demyelating multiple neuropathy (chronic icing demyelining polyradiculoneuropathy, CIDP), given hormones, propylene globulin and other treatment, the patient's symptoms improved significantlyFigure 1 Lumial MR flat sweep sacroon T2WI (Figure 1A), T1WI (Figure 1B), nerve root imaging (Figure 1C) shows significant increase in nerve roots on both sides of the lumbar 2-2; Demyelinosis, the incidence rate is about 1 to 9 cases / 100,000 people, manifested in varying degrees of limb weakness, often symmetrical, multiple, near-end suffering;due to the complex clinical manifestations of CIDP, the course of the disease is chronic progression or remission recurrence, and the symptoms are mostly atypical, often misdiagnosed in the early stagesMR examination can show nerve thickening, swelling, especially nerve root imaging can clearly show vertical abnormal morphological changes from nerve root to nerve stem, enhanced examination of nerve root intensification usually indicates that the patient is in the disease period of activity, when the patient's clinical and neuroelectrophysiological performance is not typical, MR helps to clarify the diagnosispatient scans did not see significant reinforcement and may be related to drug therapy such as hormones;.