A case of acute inflammatory demyelinating polyradiculoneuropathy in early pregnancy

Abstract

Acute or chronic inflammatory demyelinating polyradiculoneuropathy is a rare disorder that presents with weakness, hyporeflexia, and sensory loss. Treatment consists of immunosuppression and/or plasma exchange. A woman in the first trimester of pregnancy presents with flaccid quadriplegia and numbness. Electromyography demonstrated a demyelinating polyneuropathy with active denervation. The diagnosis of acute inflammatory demyelinating polyradiculoneuropathy was made. She was treated with corticosteroids and plasmapheresis. Despite slow improvement, she decided to terminate the pregnancy at 18 weeks' gestation. At 1 year postpartum she is still in remission. Inflammatory demyelinating polyradiculoneuropathy should be considered in the differential diagnosis of every pregnant woman with new onset peripheral neuropathy. It is suggested that relapse occurs three times more common during pregnancy. Plasmapheresis is the recommended treatment.