A case report describing a rare presentation of Acute Inflammatory Demyelinating Polyradiculopathy (AIDP)

Abstract

Listen

Translate article

Background: AIDP (Acute Inflammatory Demyelinating Polyradiculopathy) commonly presents as bilateral lower extremity weakness and areflexia with albuminocytologic dissociation on CSF findings. Sensory symptoms are not prominent presenting features in patients. However, Bulbar and Miller Fisher variants of AIDP are very rare. This case report highlights the unique presentation where unilateral facial nerve palsy along with perioral numbness and decreases taste sensation was the presenting symptom. Case presentation: A 33-year-old male with a past medical history of rhabdomyosarcoma s/p resection who presented with the chief complaint of numbness and dysphagia. He developed left-sided facial droop and decreased taste sensation following an episode of bronchitis six weeks ago. Pertinent positives include mild dysphagia, decreased appetite, congestion and rhinorrhea. Physical exam was not significant except for decreased sensation of the upper and lower left face, decreased sensation of the right lower face, decreased light touch of the right upper extremity, 3+ reflexes of both upper and lower extremities bilaterally. Conclusions: This case report highlights the unique presentation of Bulbar AIDP with some symptoms of Miller Fisher syndrome. Predominant sensory symptoms such as perioral numbness and decreased taste sensation might be the predominant symptoms that bring the patient to attention. Hence, it is imperative to perform a lumbar puncture to support the diagnosis of variant AIDP when prominent sensory symptoms are present.