Chan, KH

Cheung, RTF

Fong, CY

Ho, SL

Mak, W

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Title Clinical and laboratory features of local patients with chronicinflammatory demyelinating polyneuropathy (CIDP)Author(s) Chan, KH; Mak, W; Fong, CY; Cheung, RTF; Ho, SLCitationThe 5th Medical Research Conference (MRC 2000), Hong Kong,China, January 2000. In The Hong Kong Practitioner, 2000, v. 22suppl. 2, p. 52Issued Date 2000URL http://hdl.handle.net/10722/46814RightsS-N-2Ictal cerebral Single Photon Emission Computerized Tomography (SPECT) scan is a sensitive and safeinvestigation for seizure localizationGCY Fong. WY Ho*, KH Chan, RTF Cheung, SL Ho.Division of Neurology, University Department of Medicine, Queen Mary Hospital, Hong Kong.* Department of Nuclear Medicine, Queen Mary Hospital, Hong Kong.In 1997, we reported the first systemic review of interictal cerebral SPECT scan in Hong Kong. Interictalcerebral SPECT scan can detect perfusion defect, and regional cerebral blood flow (rCBF) defect was found in71% (15/21) of the patients with intractable temporal lobe epilepsy. Here we extended our study of rCBF inintractable epilepsy by ictal cerebral SPECT scan. We aimed to inject the radiopharmaceutical compoundduring a seizure under the monitoring of video-EEG telemetry. Area of hyperperfusion will reflect an increasedmetabolic demand over the epileptogenic zone. Owing to the limited half-life of the radioisotope, injection hasto be given within a 3-hour time window. To date, six attempts of ictal SPECT studies were arranged for fivepatients. Time of injection ranged from 10 to 85 seconds after the onset of the seizure. The sensitivity to detectabnormal hyperperfusion defect is 100%. Furthermore, all patients with normal interictal SPECT scan had ahyperperfusion area in the ictal studies. No complication was seen. Thus, ictal SPECT study is a sensitive andsafe investigation for localization of the epileptogenic zone.S-N-3CLINICAL AND LABORATORY FEATURES OF LOCAL PATIENTS WITH CHRONICINFLAMMATORY DEMYELINATING POLYNEUROPATHY (CIDP)KH Chan. W Mak, C Y Fong, R T F Cheung, S L HoDivision of Neurology, University Department of Medicine, Queen Mary HospitalCIDP is a progressive or relapsing disorder of the peripheral nervous system with immunological pathogeneticmechanisms. Various immunosuppressive and immunomodulating therapies are proven beneficial especiallywhen instituted early. From July 1997 to June 1999, four patients are diagnosed to have CIDP, all fulfilled thediagnostic criteria of Cornblath et al. All four patients are male and ages range from 25 to 63, one patient hadchronic renal failure of uncertain etiology and another one had T cell lymphoma treated with chemotherapyone year before onset of symptoms. All patients had sensory symptoms and symmetrical lower limb weaknesswith milder upper limb involvement. Weakness progressed rapidly in two patients leading to muscle wastingdue to secondary axonal loss. All patients had raised CSF protein ranging 0.71 to 1.03g/L but CSF oligoclonalband was negative in all patients. Electrophysiologically, lower limb F-waves are abnormal in all patients,being the most sensitive parameter. Except one patient who had mild symptoms which improved spontaneously,the other three patients respond satisfactorily to plasmapheresis followed by systemic corticosteroid. Inconclusion, local CIDP patients show satisfactory response to plasmapheresis and systemic corticosteroideven when secondary distal axonal degeneration have developed and CSF oligoclonal band tends to be negative;early diagnosis and vigorious treatment are suggested.- 52 -

Clinical and laboratory features of local patients with chronic inflammatory demyelinating polyneuropathy (CIDP)

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Clinical and laboratory features of local patients with chronic inflammatory demyelinating polyneuropathy (CIDP)

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