Missed diagnosis of chronic inflammatory demyelinating polyneuropathy in a patient with cervical myelopathy due to ossification of posterior longitudinal ligament.

Abstract

In the current study, we report a missed diagnosis of combined chronic inflammatory demyelinating polyneuropathy (CIDP) in a patient with a cervical spinal cord lesion. At 3.5 months after the onset of symptoms, a 60-year-old female with mild motor weakness and significant weight loss underwent a surgical operation for decompression of the cervical spinal cord. However, her motor weakness was severely aggravated despite the surgical treatment, and she could not walk independently at 10 months after symptom onset. Based on the results of electrophysiological and cerebrospinal fluid tests, we diagnosed her with CIDP. Considering her medical history and the results of our evaluations, we think our patient’s neurological symptoms before the surgical operation were attributed, at least in part, to CIDP. Our study shows that clinicians should consider the possibilities of other lesions in different areas even when patients have a definite lesion in the cervical spinal cord or cervical spine.