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Letter
Coexistence of chronic inflammatory demyelinating polyneuropathy and camptocormia
  1. M Terashima,
  2. H Kataoka,
  3. K Sugie,
  4. H Horikawa,
  5. S Ueno
  1. Department of Neurology, Nara Medical University, Kashihara, Nara, Japan
  1. Correspondence to Dr H Kataoka, Department of Neurology, Nara Medical University840 Shijo-cho, Kashihara, Nara 634-8522, Japan; hk55{at}naramed-u.ac.jp

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Camptocormia, first described by Brodie in 1837, is characterised by an abnormal posture of the trunk with marked flexion of the thoracolumbar spine, which increases during walking and abates while recumbent. Camptocormia can be associated with metabolic, spinal, neuromuscular and movement disorders. Recently, camptocormia has been accompanied by focal dystonia of the abdominal muscles or focal lesions of the paraspinal muscles. We describe a patient with chronic inflammatory demyelinating polyneuropathy (CIDP) and camptocormia who dramatically responded to treatment with intravenous immunoglobulins (IVIG).

Case report

A 74-year-old man who had undergone a Billroth II gastrectomy for early gastric cancer 29 years ago noticed dysesthesia of the right distal lower limb in April 2003. In August, dysesthesia developed in both distal lower limbs. In September 2007, dysesthesia extended to all four limbs, and he noticed difficulty in averting his head back. In December 2007, head ptosis and camptocormia occurred on standing and progressively worsened. In February 2008, he had to raise his chin with his hand to see in front of himself. In March, he was admitted to our hospital. Superficial sensation was mildly impaired in all four distal limbs, and vibratory sensation was moderately disturbed in the lower limbs. The Manual Muscle Test (MMT) scores based on a 0 to 5 point scale were 4 in the four distal limbs. The deep tendon reflexes were decreased in all four limbs, with no …

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