Chronic Inflammatory Demyelinating Polyneuropathy with Atypical Symptoms: A Rare Case of Tongue Fasciculation and Facial Muscle Weakness

This case report presents a 55-year-old man, with a history of hypertension, who developed an unusual and atypical presentation of chronic inflammatory demyelinating polyneuropathy (CIDP). Over 3 months, the patient experienced progressive limb weakness ascending from lower limbs to upper limbs wit...

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Main Authors: Shafiq ur Rehman, Saba Zaidi, Mahzareen
Format: Article
Language:English
Published: Health Research Institute (HRI), National Institute of Health (NIH) 2025-02-01
Series:Pakistan Journal of Medical Research
Online Access:https://www.pjmr.org.pk/index.php/pjmr/article/view/682
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author Shafiq ur Rehman
Saba Zaidi
Mahzareen
author_facet Shafiq ur Rehman
Saba Zaidi
Mahzareen
author_sort Shafiq ur Rehman
collection DOAJ
description This case report presents a 55-year-old man, with a history of hypertension, who developed an unusual and atypical presentation of chronic inflammatory demyelinating polyneuropathy (CIDP). Over 3 months, the patient experienced progressive limb weakness ascending from lower limbs to upper limbs with marked tongue fasciculations and facial muscle weakness without dysarthria or dysphagia. While cranial nerve involvement has been documented in CIDP, cases featuring the hypoglossal nerve are much less frequent than those with the facial nerve. This makes the occurrence of both happening at the same time quite rare. Diagnosing atypical presentations of CIDP can be tricky, and offer a challenge for neurologists in daily practice. A comprehensive diagnostic workup that could include blood work, cerebrospinal fluid analysis, and a nerve conduction study is required to confirm the diagnosis and rule out potential other causes. Effective management in this case included several inpatient plasmapheresis sessions and administration of steroids, which led to significant clinical improvement in the patient’s symptoms. These breakthroughs are essential for clinicians to promptly diagnose and treat patients suffering from the same diseases.
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institution Kabale University
issn 0030-9842
language English
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publisher Health Research Institute (HRI), National Institute of Health (NIH)
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series Pakistan Journal of Medical Research
spelling doaj-art-ab365ff864d446aaa3d2bea1ea3016a62025-02-12T01:06:29ZengHealth Research Institute (HRI), National Institute of Health (NIH)Pakistan Journal of Medical Research0030-98422025-02-01634Chronic Inflammatory Demyelinating Polyneuropathy with Atypical Symptoms: A Rare Case of Tongue Fasciculation and Facial Muscle WeaknessShafiq ur Rehman0Saba Zaidi1Mahzareen2Liaquat National Hospital, Karachi.Liaquat National Hospital, Karachi.Liaquat National Hospital, Karachi. This case report presents a 55-year-old man, with a history of hypertension, who developed an unusual and atypical presentation of chronic inflammatory demyelinating polyneuropathy (CIDP). Over 3 months, the patient experienced progressive limb weakness ascending from lower limbs to upper limbs with marked tongue fasciculations and facial muscle weakness without dysarthria or dysphagia. While cranial nerve involvement has been documented in CIDP, cases featuring the hypoglossal nerve are much less frequent than those with the facial nerve. This makes the occurrence of both happening at the same time quite rare. Diagnosing atypical presentations of CIDP can be tricky, and offer a challenge for neurologists in daily practice. A comprehensive diagnostic workup that could include blood work, cerebrospinal fluid analysis, and a nerve conduction study is required to confirm the diagnosis and rule out potential other causes. Effective management in this case included several inpatient plasmapheresis sessions and administration of steroids, which led to significant clinical improvement in the patient’s symptoms. These breakthroughs are essential for clinicians to promptly diagnose and treat patients suffering from the same diseases. https://www.pjmr.org.pk/index.php/pjmr/article/view/682
spellingShingle Shafiq ur Rehman
Saba Zaidi
Mahzareen
Chronic Inflammatory Demyelinating Polyneuropathy with Atypical Symptoms: A Rare Case of Tongue Fasciculation and Facial Muscle Weakness
Pakistan Journal of Medical Research
title Chronic Inflammatory Demyelinating Polyneuropathy with Atypical Symptoms: A Rare Case of Tongue Fasciculation and Facial Muscle Weakness
title_full Chronic Inflammatory Demyelinating Polyneuropathy with Atypical Symptoms: A Rare Case of Tongue Fasciculation and Facial Muscle Weakness
title_fullStr Chronic Inflammatory Demyelinating Polyneuropathy with Atypical Symptoms: A Rare Case of Tongue Fasciculation and Facial Muscle Weakness
title_full_unstemmed Chronic Inflammatory Demyelinating Polyneuropathy with Atypical Symptoms: A Rare Case of Tongue Fasciculation and Facial Muscle Weakness
title_short Chronic Inflammatory Demyelinating Polyneuropathy with Atypical Symptoms: A Rare Case of Tongue Fasciculation and Facial Muscle Weakness
title_sort chronic inflammatory demyelinating polyneuropathy with atypical symptoms a rare case of tongue fasciculation and facial muscle weakness
url https://www.pjmr.org.pk/index.php/pjmr/article/view/682
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AT sabazaidi chronicinflammatorydemyelinatingpolyneuropathywithatypicalsymptomsararecaseoftonguefasciculationandfacialmuscleweakness
AT mahzareen chronicinflammatorydemyelinatingpolyneuropathywithatypicalsymptomsararecaseoftonguefasciculationandfacialmuscleweakness