Neuropathy Inflammatory and Immune-Mediated Neuropathy 1 — Questions and Answers
Question 1: What is the most common acute inflammatory demyelinating polyneuropathy?
- Guillain-Barré Syndrome (GBS) (Correct answer)
- Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
- Multifocal Motor Neuropathy
- Vasculitic Neuropathy
Correct answer: Guillain-Barré Syndrome (GBS)
GBS is the most common acute inflammatory demyelinating polyneuropathy, typically presenting with rapidly ascending limb weakness following an infection.
Question 2: What duration of symptoms distinguishes CIDP from Guillain-Barré Syndrome?
- Symptoms lasting more than 2 weeks
- Symptoms lasting more than 4 weeks
- Symptoms lasting more than 8 weeks (Correct answer)
- Symptoms lasting more than 6 months
Correct answer: Symptoms lasting more than 8 weeks
CIDP is defined by a progressive or relapsing course lasting more than 8 weeks, which differentiates it from the acute monophasic course of GBS.
Question 3: Which treatment is considered first-line for Guillain-Barré Syndrome?
- Oral corticosteroids alone
- Intravenous immunoglobulin (IVIG) or plasmapheresis (Correct answer)
- Broad-spectrum antibiotics
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
Correct answer: Intravenous immunoglobulin (IVIG) or plasmapheresis
IVIG and plasmapheresis are equally effective first-line treatments for GBS, both accelerating recovery by modulating or removing pathogenic immune factors.
Question 4: What is the classic cerebrospinal fluid (CSF) finding in Guillain-Barré Syndrome?
- Elevated white blood cells with normal protein
- Decreased glucose with elevated protein
- Elevated protein with normal white blood cell count (albuminocytologic dissociation) (Correct answer)
- Normal protein and normal white blood cell count
Correct answer: Elevated protein with normal white blood cell count (albuminocytologic dissociation)
Albuminocytologic dissociation — elevated CSF protein without a corresponding increase in white blood cells — is the hallmark CSF finding in GBS.
Question 5: Which antibody is strongly associated with Multifocal Motor Neuropathy (MMN)?
- Anti-MAG IgM antibodies
- Anti-GM1 IgM antibodies (Correct answer)
- Anti-Hu antibodies
- Anti-GQ1b antibodies
Correct answer: Anti-GM1 IgM antibodies
Anti-GM1 IgM antibodies are found in approximately 50% of MMN patients and help distinguish MMN from ALS and other motor neuron diseases.
Question 6: How does vasculitic neuropathy most typically present?
- Symmetric distal sensorimotor polyneuropathy
- Asymmetric nerve involvement due to ischemia from vessel inflammation (Correct answer)
- Pure sensory neuropathy affecting only small fibers
- Proximal motor-dominant demyelinating neuropathy
Correct answer: Asymmetric nerve involvement due to ischemia from vessel inflammation
Vasculitic neuropathy causes asymmetric ischemic nerve injury because inflammation occludes the vasa nervorum (blood vessels supplying nerves), leading to multifocal infarction.
Question 7: Approximately what percentage of GBS patients recover the ability to walk independently within 6 months?
- About 20-30%
- About 50%
- About 85% (Correct answer)
- Nearly 100%
Correct answer: About 85%
Approximately 85% of GBS patients regain independent ambulation within 6 months, though some may have persistent fatigue, pain, or mild weakness.
Neuropathy Inflammatory and Immune-Mediated Neuropathy 1
What is the most common acute inflammatory demyelinating polyneuropathy?