Sensory-Predominant Chronic Inflammatory Demyelinating Polyneuropathy in a Patient with Parainfectious Limbic Encephalitis (case report)
Abstract
We report a patient with chronic herpes infection, which manifested as parainfectious limbic encephalitis (PILE) and sensory-predominant chronic inflammatory demyelinating polyneuropathy (SP-CIDP). It is demonstrated that persisting herpes infection associated with immunodeficiency can facilitate two pathological processes: direct viral damage of limbic structures and autoimmune damage to myeline sheath of peripheral and cranial nerves. Description of the case includes clinical presentation and diagnosis of SP-CIDP and PILE. CIDP is an autoimmune disorder, characterized by damage of myelin sheath of peripheral and cranial nerves. It is thought that CIDP accounts for 20-50% cases of undiagnosed polyneuropathy. The contribution of Herpesviridae family to development of CIDP is a matter of debate. PILE associated with Herpesviridae infection is one of the most common forms of chronic herpetic encephalitis, characterized by abnormalities in function of limbic system (hippocampus and amygdala), with protracted course of disease and frequent exacerbations. Parainfectious limbic encephalitis is caused by direct viral damage to limbic structures.
We suggest a new diagnostic algorithm of SP-CIDP, which includes nerve conduction study, stabilometry with use of EU standard Rhomberg’s test, computerized pallesthesiometry (CP) of distal parts of upper and lower extremities, computerized thermosensometry (CTS) for evaluation of thermoception and pain threshold for cold and hot stimuli. This algorithm can be used in the setting of outpatient clinic by neurologists and general practitioners. The diagnostic methods utilized in this algorithm, such as CP and CTS, are safe, simple, and non-invasive and may have broad application.
About the Authors
T. E. Popova
FGAOU VPO “North-Eastern Federal University named after M.K. Ammosov”; GBOU VPO “Krasnoyarsk State Medical University named after Professor V.F. VoinoYasenetsky”
Russian Federation
Russian Federation
Popova Tatyana Egorovna – Ph.D., docent at Branch of Medical Genetics and Clinical Neurophysiology, Post-diploma Education Institute
Address: 660021, Krasnoyarsk city, ulitsa Karla Marksa, 124
8(391)2212449
T. Y. Nikolaeva
FGAOU VPO “North-Eastern Federal University named after M.K. Ammosov”
Russian Federation
Russian Federation
Nikolaeva Tatyana Yakovlevna – M.D., professor, head of Branch of Neurology and Psychiatry
Address: 677000, Yakutsk city, ulitsa Oyunskogo, 27
8(4112)363046
N. A. Schnayder
GBOU VPO “Krasnoyarsk State Medical University named after Professor V.F. VoinoYasenetsky”
Russian Federation
Russian Federation
Schnayder Natalya Alexeevna – M.D., professor, head of Branch of Medical Genetics and Clinical Neurophysiology, Post-diploma Education Institute
Address: 660021, Krasnoyarsk city, ulitsa Karla Marksa, 124
8(391)2212449
M. M. Petrova
GBOU VPO “Krasnoyarsk State Medical University named after Professor V.F. VoinoYasenetsky”
Russian Federation
Russian Federation
Petrova Marina Mikhailovna – M.D., professor, head of Branch of Outpatient Inner Diseases and Family Medicine, Post-diploma Education Institute
Address: 660022, Krasnoyarsk city, ulitsa P. Zheleznyaka, 1,
8(391)2280860
A. A. Semenov
FGAOU VPO “North-Eastern Federal University named after M.K. Ammosov”
Russian Federation
Russian Federation
Semenov Artem Arkadievich – post-graduate student at Branch of Neurology and Psychiatry, Medical institute
Address: 677000, Yakutsk city, ulitsa Oyunskogo, 27
8(4112)363046
O. V. Pen
FGAOU VPO “Siberian Federal University”
Russian Federation
Russian Federation
Pen Olga Vladimirovna – student of Branch of Informational Systems
Address: 660049, Krasnoyarsk city, ulitsa Kirenskogo, 26, korpus “ULK”
8(913)1968408
U. S. Panina
GBOU VPO “Krasnoyarsk State Medical University named after Professor V.F. VoinoYasenetsky”
Russian Federation
Russian Federation
Panina Yulia Sergeevna – researcher at Interbranch Laboratory of Medical Genetics
Address: 660021, Krasnoyarsk city, ulitsa Karla Marksa, 124
8(391)2212449
A. V. Muravyova
GBOU VPO “Krasnoyarsk State Medical University named after Professor V.F. VoinoYasenetsky”
Russian Federation
Russian Federation
Muravyova Anastasia Vladimirovna – assistant at Interbranch Laboratory of Medical Genetics
Address: 660021, Krasnoyarsk city, ulitsa Karla Marksa, 124
8(391)2212449
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Review
For citations:
Popova T.E., Nikolaeva T.Y., Schnayder N.A., Petrova M.M., Semenov A.A., Pen O.V., Panina U.S., Muravyova A.V. Sensory-Predominant Chronic Inflammatory Demyelinating Polyneuropathy in a Patient with Parainfectious Limbic Encephalitis (case report). Yakut Medical Journal. 2014;(4):84-89.
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