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Tonic pupils: an unusual autonomic involvement in chronic inflammatory demyelinating polyneuropathy (CIDP).

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Title: Tonic pupils: an unusual autonomic involvement in chronic inflammatory demyelinating polyneuropathy (CIDP).
Authors: Escorcio-Bezerra, Marcio Luiz (AUTHOR), Manzano, Gilberto Mastrocola (AUTHOR), Bichuetti, Denis Bernardi (AUTHOR), Nunes, Karlo Faria (AUTHOR), Correa, Daniele Sales Alves (AUTHOR), Oliveira, Acary Souza Bulle (AUTHOR), Baeta, Alex Machado (AUTHOR)
Source: Neurological Sciences. Aug2019, Vol. 40 Issue 8, p1725-1727. 3p. 1 Color Photograph, 1 Chart.
Subjects: Polyneuropathies, School children, Guillain-Barré syndrome, Dysautonomia, Nerve fibers, Cranial nerves
Abstract: Background: Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neuropathy which affects mainly large myelinated axons and has a typically mild autonomic dysfunction mainly from postganglionic nerve fiber involvement.Case Report: We report here an acute onset CIDP initially diagnosed as Guillain-Barré syndrome (GBS), unresponsive to treatment with intravenous immunoglobulin (IVIg), which later responded to plasmapheresis and corticoids. The patient had a markedly distal demyelination, prominent cranial nerve involvement and, interestingly, bilateral fixed dilated pupils. Despite complete clinical recovery, this neurological sign remained.Conclusions: Tonic pupils have previously been described in different neurologic conditions, including GBS, but not yet in acute onset CIDP or in variants with predominantly distal demyelination. It differs from the classical Adie's pupil because it lacks the light-near dissociation. This case report expands the range of possible autonomic signs in acute onset CIDP, which could help physicians establish optimal treatment strategies earlier on. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Tonic pupils: an unusual autonomic involvement in chronic inflammatory demyelinating polyneuropathy (CIDP).
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  Data: <searchLink fieldCode="AR" term="%22Escorcio-Bezerra%2C+Marcio+Luiz%22">Escorcio-Bezerra, Marcio Luiz</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Manzano%2C+Gilberto+Mastrocola%22">Manzano, Gilberto Mastrocola</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bichuetti%2C+Denis+Bernardi%22">Bichuetti, Denis Bernardi</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nunes%2C+Karlo+Faria%22">Nunes, Karlo Faria</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Correa%2C+Daniele+Sales+Alves%22">Correa, Daniele Sales Alves</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Oliveira%2C+Acary+Souza+Bulle%22">Oliveira, Acary Souza Bulle</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Baeta%2C+Alex+Machado%22">Baeta, Alex Machado</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Aug2019, Vol. 40 Issue 8, p1725-1727. 3p. 1 Color Photograph, 1 Chart.
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  Data: <searchLink fieldCode="DE" term="%22Polyneuropathies%22">Polyneuropathies</searchLink><br /><searchLink fieldCode="DE" term="%22School+children%22">School children</searchLink><br /><searchLink fieldCode="DE" term="%22Guillain-Barré+syndrome%22">Guillain-Barré syndrome</searchLink><br /><searchLink fieldCode="DE" term="%22Dysautonomia%22">Dysautonomia</searchLink><br /><searchLink fieldCode="DE" term="%22Nerve+fibers%22">Nerve fibers</searchLink><br /><searchLink fieldCode="DE" term="%22Cranial+nerves%22">Cranial nerves</searchLink>
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  Data: <bold>Background: </bold>Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neuropathy which affects mainly large myelinated axons and has a typically mild autonomic dysfunction mainly from postganglionic nerve fiber involvement.<bold>Case Report: </bold>We report here an acute onset CIDP initially diagnosed as Guillain-Barré syndrome (GBS), unresponsive to treatment with intravenous immunoglobulin (IVIg), which later responded to plasmapheresis and corticoids. The patient had a markedly distal demyelination, prominent cranial nerve involvement and, interestingly, bilateral fixed dilated pupils. Despite complete clinical recovery, this neurological sign remained.<bold>Conclusions: </bold>Tonic pupils have previously been described in different neurologic conditions, including GBS, but not yet in acute onset CIDP or in variants with predominantly distal demyelination. It differs from the classical Adie's pupil because it lacks the light-near dissociation. This case report expands the range of possible autonomic signs in acute onset CIDP, which could help physicians establish optimal treatment strategies earlier on. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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