What am I suffering from?

[venkatasu]

Respected Doctors who gave valuable suggestion in this forum. Thank you very much for your great service. I am from India. In march 2010 I was operated in my right leg due to a crack in my leg with the help of screws and plates. After that I was slowly recuperating and was walking with the help of walker. In November 2010 I developed a flu like symptom which lasted for 2 to 3 days. After that slowly I noticed a slight weakness in my legs but since I was recuperating from my operation i thought it may be due to that. Within a few week I completely lost my ability to move my legs without the help of hand and was bedridden. MRI spine is normal. Ortho opinion of spine was nothing to worry about spine. I went to a neurologist after a span of 2 months in feb 2011. He took blood tests, spine tap CpK(which is borderline elevation) and nerve conduction study which was abnormal. I was hospitalized and IV prednisolone was given. They discharged after one week with the advice of Physio therapy with the diagnosis of LGMD (likely) or Auto immune paresis (likely). I was simply given b1-b12 tablets at the time of discharge and sent home. They told me to do muscle biopsy. Frustrated I saw Alternative medicine doctor which was of no use. I took treatment with that AM doctor for 2 months. So I went to another neurologist recently for second opinion who took Cpk which was normal, Vit-D which was lower and nerve study which was abnormal. He said that I was likely suffering from CIDP and prescribed Calcium tablets, Neurobion tablets and Azathioprine tablets for 1 month. Please help. Am I suffering CIDP or GBS or LGMD.
P.S.
I worked as a school teacher and was very active with long standing hours and frequent climbing of stairs during my tenure in the job and there were no signs of tiredness/weakness until this episode which happened in the month of December 2010 after the flu like symptoms. The second neurologist says it may not be LGMD as the symptoms was acute.

[venkatasu]

Thank you very much doctor. I have had a spinal tap which revealed nothing (two months after the episode). Do I have LGMD as told by the first neuro or GBS? Till date I have no improvement in my symptoms

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

CIDP is a chronic form of peripheral demyelinating neuropathy that can result from an infectious source. One such source has been described in campylobacter infections, which is a GI infection. Initially this condition will present with numbness/sensory changes beginning in the feet and progressing upwards. The major feature is weakness that is symmetric. An EMG/NCS is typically used to diagnose (~3 weeks post onset of symptoms). A procedure called a lumbar puncture (aka “spinal tap”) may also be indicated in the acute phase. Regarding prognosis, the body will begin to “heal” itself over 1-6 months post infection. After two years, there is usually none, if any, improvement. Treatment options initially may include IVIG or plasmapheresis and/or steroids.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.