Chronic immune sensory polyradiculopathy

Sinnreich, Michael; Klein, Christopher J.; Daube, Jasper R.; Engelstad, Ja Nean K.; Spinner, Robert J.; Dyck, Peter J.

doi:10.1212/01.wnl.0000142507.12763.58

Cited by 191 publications

(156 citation statements)

References 31 publications

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“…Clinically, she presented similarly to previously reported patients with chronic immune sensory polyradiculopathy. 13 These patients presented with sensory ataxia, frequent falls, sensory loss with preserved sensory nerve action potentials but abnormal somatosensory evoked potentials, elevated CSF protein, enlarged lumbar nerve roots on MRI, and inflammatory infiltrates with onion-bulb formation in lumbar sensory rootlet biopsies.…”

Section: Discussionmentioning

confidence: 99%

Erratum: Inflammatory hypertrophic cauda equina following intrathecal neural stem cell injection

2013

Muscle and Nerve

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Introduction: Potential benefit from stem cell treatments has more patients seeking treatment without understanding possible risks. Methods: We describe a woman who presented with progressive bilateral leg pain, numbness, and gait difficulties. A prior stroke, macular degeneration, osteoarthritis, and depression, led her to receive intrathecal neural stem cell therapy overseas 1 year before onset of symptoms. Results: Imaging showed marked enlargement of lumbosacral roots of the cauda equina, which was not seen before stem cell treatment. Electrodiagnostic studies confirmed chronic multiple lumbosacral radiculopathies. Biopsy of a lumbar dorsal sensory root showed myelinated fiber degeneration and loss, with endoneurial inflammation. The hypertrophic inflammatory cauda equina syndrome was potentially triggered by the prior intrathecal neural stem cell injection. Conclusions: Safety of intrathecal stem cell treatments is not regulated routinely in overseas stem cell facilities. We wish to bring this potential complication to the attention of health care providers. 48: 831-835, 2013 The potential benefit for stem cell therapy to repair, restore, replace, and regenerate damaged tissues has many patients with chronic neurological conditions excited about possible treatments. Research in this area continues to grow throughout the world. The U.S. National Institute of Health reports over 45 registered trials world-wide that relate to stem cell therapy and spinal cord injury alone. Muscle Nerve1 There is no way to know how many unregistered and uncontrolled treatments are offered in "notorious" stem cell clinics for chronic conditions that range from rejuvenation to cerebral palsy, stroke, Parkinson disease, traumatic brain and spinal cord injury, multiple sclerosis, and amyotrophic lateral sclerosis.2-5 Along with increased research, more and more patients are seeking stem cell therapy before the safety and efficacy of such treatments have been established. Some experts have concerns that the hope and expectations patients have for cures cannot be met. This may leave patients vulnerable to nonregulated providers of stem cell treatments that are potentially harmful. 3,6 Stem cells have 3 fundamental properties. First, they have a high proliferative potential. Second, they are capable of self-renewal. Third, they have the ability to differentiate into multiple cell types.These properties are what make stem cell therapy so attractive, especially in the setting of central nervous system injury, such as acute spinal cord injury, prior stroke, multiple sclerosis, and amyotrophic lateral sclerosis. However, these same properties, without a full understanding or control of their subsequent activities, are what potentially make stem cell therapy dangerous. Cells in a different environment may multiply, form tumors, or leave the site of origin and migrate somewhere else in the body. 4,5 In this case report, we postulate that intrathecal administration of neural stem cells may have induced inflammatory hypertroph...

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Section: Discussionmentioning

confidence: 99%

Erratum: Inflammatory hypertrophic cauda equina following intrathecal neural stem cell injection

2013

Muscle and Nerve

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“…Of the 5 patients with the pure sensory CIDP variant, 4 were in group 2, (so without electrodiagnostic criteria); and with the realization of SEPs, we could have established the diagnosis of CIDP. For this variant, the use of SEPs is the most useful because the study of NCSs is often normal (Sinnreich et al, 2004). Thus, the collection of SEPs enabled the identification of abnormalities of proximal demyelination in our 16 patients, which included patients who did not meet the electrodiagnostic criteria for CIDP (group 2).…”

Section: Discussionmentioning

confidence: 99%

Somatosensory Evoked Potentials in Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Salhi¹,

Corcia

Remer³

et al. 2014

Journal of Clinical Neurophysiology

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“…8 Our patient was treated with another course of 5 days of IVIg followed by 1 g/kg over 2 days monthly for 4 months and prednisone 60 mg daily. His neurologic status did not improve with therapy, suggesting that he had developed irreversible damage to his proximal nerve segments.…”

Section: Sectionmentioning

confidence: 99%

“…8 The clinical, laboratory, electrophysiologic, radiologic, and pathologic features of CISP suggest dorsal root inflammation as the underlying etiology. Our patient's SNAPs and CMAPs were reduced, suggesting some degree of ganglionopathy or axonal neuropathy.…”

Section: Sectionmentioning

confidence: 99%