This document describes a case of a 32-year-old male who presented with weakness in all four limbs that progressed over a week. Based on examination and investigations, he was diagnosed with recurrent quadriparesis likely due to an autoimmune etiology of chronic inflammatory demyelinating polyneuropathy (CIDP) associated with systemic lupus erythematosus (SLE). He showed improvement in symptoms with intravenous steroids and plasma exchange.

1. A CASE OF FLACCID QUADRIPARESIS S.GEETHALAKSHMI PROF DR.MAGESHKUMAR’S UNIT

15. NERVE CONDUCTION STUDIES SECOND EPISODE THIRD EPISODE UPPER LIMB SNAPS – NORMAL AMPLITUDE PRESERVED F WAVE ABSENT IN LT ULNAR, MEDIAN & RT ULNAR NERVES SNAPS – NORMAL CMAP & F WAVE, LT ULNAR LATENCY PROLONGED Conduction blocks+ LOWER LIMB SNAPS – NORMAL VELOCITY F WAVE ABSENT IN ALL NERVES SNAPS –NORMAL CMAP –LATENCY PROLONGED F WAVE NOT OBTAINED AMPLITUDE DECREASED Conduction blocks+

29. NERVE BIOPSY- ITS ROLE The diagnostic utility of nerve biopsy for suspected CIDP is controversial . Nerve biopsy is used mainly when other studies fail to clearly establish the diagnosis of CIDP, particularly when electrophysiologic criteria for demyelination are not met. #A major limitation of nerve biopsy is suboptimal sensitivity and specificity #CIDP is a multifocal disorder, and motor nerve fibers tend to be more affected than sensory nerves (the usual nerves used for biopsy). As a result, the biopsy sample may not demonstrate the demyelination. In addition, the inflammatory component of CIDP may not be prominent and thus may not be apparent on biopsy.

40. Nervous system n SLE

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