Hypertrophic Lumbosacral Nerve Roots in a 19-Year-Old Woman with Chronic Inflammatory Demyelinating Polyneuropathy

Abdul Ghani Zghair, Muna; Nori, Wassan; Atia, Ahmed

doi:10.32894/kjms.2025.164609.1186

Hypertrophic Lumbosacral Nerve Roots in a 19-Year-Old Woman with Chronic Inflammatory Demyelinating Polyneuropathy

Document Type : Image in Clinical Practice

Authors

Muna Abdul Ghani Zghair ¹

Wassan Nori ²

Ahmed Atia ³

¹ Department of Radiology, College of Medicine, Mustansiriyah University, Baghdad, Iraq

² Department of Obstetrics and Gynecology, College of Medicine, Mustansiriyah University, Baghdad, Iraq

³ Department of Anesthesia and Intensive Care, Faculty of Medical Technology, The University of Tripoli, Tripoli, Libya

https://doi.org/10.32894/kjms.2025.164609.1186

Abstract

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is an acquired immune-mediated neuropathy that rarely affects adolescents. We report a 19-year-old woman with a three-month history of progressive symmetrical limb weakness, sensory loss, gait disturbance, and global areflexia. Nerve conduction studies demonstrated acquired demyelinating polyneuropathy with conduction block and temporal dispersion, favouring CIDP over hereditary or neoplastic mimics. Lumbar spine MRI on a 1.5-T system revealed diffuse hypertrophic thickening of the lumbosacral nerve roots from L2 to S1, near-complete obliteration of the spinal canal, loss of cerebrospinal fluid signal, and posterior vertebral body scalloping. Despite the absence of contrast-enhanced and fat-suppressed sequences, the imaging and electrophysiological findings supported a diagnosis of CIDP. The patient showed marked clinical improvement after corticosteroid therapy. This case highlights the importance of considering CIDP in young adults with chronic neuropathy and characteristic MRI features.

Keywords

Chronic inflammatory demyelinating polyneuropathy

Hypertrophic lumbosacral nerve roots

Adolescent neuropathy

Subjects