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PO.17 MMN evolving into CIDP precipitated by IVF
  1. J Vaz,
  2. H Gibson
  1. Jersey General Hospital, UK

Abstract

We describe a patient in whom the symptoms presented following an egg collection procedure as part of IVF procedure. She initially presented with weakness in one lower limb which then progressed to the other limb and while there was initial sparing of the upper limbs the disease later progressed to involve both upper limbs. Our patient presented clinical and electrophysiological features that could be partly be attributed to chronic inflammatory demyelinating polyradiculopathy (CIDP) and partly to multifocal motor neuropathy with conduction block (MMN)—which led us to a hypothesis of being a case of MMN evolving into a motor dominant CIDP Her symptoms started in one lower limb sparing the upper limbs, progression of the disease resulted in broadly symmetrical involvement of all four limbs. Again while the symptoms started in the distal lower limb—disease progression fairly quickly involved proximal and distal muscle groups in both limbs While her deep tendon reflexes were reduced in the lower limb, she was areflexic in the upper limb. MMN evolving into motor sensory CIDP is rare and this may be a first case of MMN evolving into CIDP in a patient whose symptoms were precipitated by IVF and her symptoms evolved during her pregnancy into motor dominant CIDP There were no sensory deficits MMN and CIDP respond well to IVIg as did our patient. She went on to deliver a healthy child. Repeat nerve conduction study continues to show mild residual motor conduction block.

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