Anthony Yao1, Helen Chan2, Richard A L Macdonell3, Neil Shuey4, Jwu Jin Khong5. 1. Department of Ophthalmology, Austin Health, Heidelberg, Victoria, Australia; Department of Neurology, Austin Health, Heidelberg, Victoria, Australia. Electronic address: anthony.yao@austin.org.au. 2. Department of Ophthalmology, Austin Health, Heidelberg, Victoria, Australia; The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia. 3. Department of Neurology, Austin Health, Heidelberg, Victoria, Australia. 4. The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia. 5. Department of Ophthalmology, Austin Health, Heidelberg, Victoria, Australia; The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Centre for Eye Research Australia, Department of Surgery, University of Melbourne, East Melbourne, Victoria, Australia.
Abstract
PURPOSE: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) presents uncommonly with cranial nerve involvement with ophthalmological implications. METHODS: We report the case of a 37year-old man who developed CIDP which manifested as progressive and relapsing bilateral facial nerve palsy with lagophthalmos and exposure keratopathy, in the setting of treatment of Crohn's disease with the anti-TNF-alpha agent adalimumab. RESULTS: Symptoms gradually improved over the course of several months following withdrawal of adalimumab and treatment with intravenous immunoglobulin (IVIg) and oral prednisolone. CONCLUSION: Bilateral facial nerve involvement occurs uncommonly as a feature of CIDP in its classic form. The prognosis is good for recovery of facial nerve function with discontinuation of anti-TNF-alpha therapy and concurrent use of steroid and intravenous immunoglobulin in this case.
PURPOSE: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) presents uncommonly with cranial nerve involvement with ophthalmological implications. METHODS: We report the case of a 37year-old man who developed CIDP which manifested as progressive and relapsing bilateral facial nerve palsy with lagophthalmos and exposure keratopathy, in the setting of treatment of Crohn's disease with the anti-TNF-alpha agent adalimumab. RESULTS: Symptoms gradually improved over the course of several months following withdrawal of adalimumab and treatment with intravenous immunoglobulin (IVIg) and oral prednisolone. CONCLUSION: Bilateral facial nerve involvement occurs uncommonly as a feature of CIDP in its classic form. The prognosis is good for recovery of facial nerve function with discontinuation of anti-TNF-alpha therapy and concurrent use of steroid and intravenous immunoglobulin in this case.