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Case Reports
. 2024 Jul 15;16(7):e64578.
doi: 10.7759/cureus.64578. eCollection 2024 Jul.

Chronic Inflammatory Demyelinating Polyneuropathy Following Lumbar Spine Surgery in a Patient With Sarcoidosis

Conor Jones  1 , Alexander P Hughes  1
Affiliations
Case Reports

Chronic Inflammatory Demyelinating Polyneuropathy Following Lumbar Spine Surgery in a Patient With Sarcoidosis

Conor Jones et al. Cureus. .

Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare relapsing-remitting autoimmune polyneuropathy that targets peripheral nerves and has been associated in the literature with sarcoidosis. The goal of this study is to report the clinical case of a 61-year-old man with sarcoidosis who developed CIDP following lumbar spine surgery. The patient presented at their clinic visit with lumbar back pain and underwent a dome laminoplasty at L2-3, L3-4, and L4-5 with no known complications. Approximately four hours postoperatively, he developed bilateral lower extremity weakness most prominent along the tibialis anterior and extensor hallucis longus (L4-S1) as well as saddle anesthesia. An MRI revealed no acute changes concerning compression. Electromyography (EMG) was performed six months postoperatively, which revealed absent F waves along the peroneal and tibial nerves as well as decreased amplitude consistent with an underlying axonal neuropathy. He was referred to a neurologist for a second opinion where a diagnosis of CIDP was made. Intravenous immune globulin treatment was initiated, and the patient felt improvement in his symptoms. This case highlights the association between sarcoidosis and CIDP and discusses the pathophysiology of the disease. In patients with sarcoidosis and weakness following lumbar surgery with a negative MRI, CIDP should be on the differential.

Keywords: chronic inflammatory demyelinating polyneuropathy; dome laminoplasty; lumbar spine surgery; neuropathy; sarcoidosis.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Hospital for Special Surgery issued approval IRB#2020-0927. Institutional Review Board (IRB) approval was obtained for this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Postoperative T2-weighted MRI of the lumbar spine demonstrating no compressive elements (hematoma or seroma) on the spinal cord.
See this image and copyright information in PMC

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