suggested that sulfatide antibodies can serve as the basis for diagnosing peripheral neuropathy
suggested that sulfatide antibodies can serve as the basis for diagnosing peripheral neuropathy. 24 Furthermore, several studies have found that sulfatide antibodies may be most prominent in axonal sensory neuropathies, similar to the case under consideration. 25 Significant elevations in sulfatide levels have been observed in several brain regions, such as the diencephalon, brainstem, cerebellum, and telencephalon. antibody, peripheral nervous system, cranial nerve, case report Introduction Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a condition that mainly affects the peripheral nervous system and manifests with a wide range of clinical symptoms. Although rare, CIDP can involve the central nervous system. The diagnosis of CIDP relies on clinical manifestations reinforced by cerebrospinal fluid (CSF) analysis and electrophysiological and histopathological findings. 1 The incidence of cranial nerve involvement in CIDP is low, with a reported rate of approximately 15%. 2 Facial and oculomotor nerve disorders are frequently observed, 3C5 while trigeminal and hypoglossal nerve disorders have also been documented.6,7 However, ophthalmoplegia is only present in 3% to 8% 5-Bromo Brassinin of cases. 8 Pathologically, segmental demyelination is caused by antibody-dependent phagocytosis of myelin by macrophages. 9 A limited number of reports have suggested the presence of anti-sulfatide IgM antibodies in CIDP patients with ocular palsy, and the underlying pathogenesis is not fully understood. We observed an unconventional case of a patient with CIDP, with the detection of anti-sulfatide IgM antibodies serving as a positive immunological indication. This report provides a retrospective analysis and literature review to explore the possible mechanisms involved in this case of CIDP. Case presentation A 56-year-old man with a medical history of hypertension presented with a gradual onset of numbness in his hands and feet that progressed to his upper and lower limbs over 5 months. One week before admission, 5-Bromo Brassinin the patient experienced double vision and was referred to our hospital 12 hours after the onset of weakness in his right lower limb. The patient had received the second dose of the coronavirus disease 2019 (COVID-19) vaccine 6 months prior to admission. There was no history of fever, but the patient reported occasional headaches and vertigo without vomiting. The patient did not exhibit any autonomic or cardiac symptoms, nor did he display any signs of connective tissue disease. There was no familial history of neurological disorders, and no recent substance abuse, alcoholism, or exposure to harmful substances was noted. Upon examination, the patient had limited abduction in both eyes, but no other eye movement impairments or nystagmus were detected in any other directions. The patient had impaired sensation to pinprick and light touch on the right side of the face, but the other cranial nerves were intact. The patient had grade IV muscle strength in the right lower limb. All sensory modalities were impaired in each limb, including light touch, vibration, pinprick, temperature, and proprioception. Both the bilateral finger-to-nose test and heel knee-shin test 5-Bromo Brassinin indicated stable results. The patient had weak bilateral knee tendons, and the bilateral Babinski sign was negative. A lumbar puncture procedure revealed albuminocytologic dissociation, as evidenced by an elevated protein level of 0.84 g/L and the absence of cells in the CSF, and the glucose level was within normal limits. A comprehensive panel of tests was conducted to measure ganglioside autoimmune antibodies, including IgM and IgG antibody tests for multiple types of gangliosides, such as sulfatide, GM1, GM2, GM3, GM4, GD1a, 5-Bromo Brassinin GD1b, GD2, GD3, GT1a, GT1b, 5-Bromo Brassinin and Gq1b. The test results revealed a high anti-sulfatide IgM titer in the serum and sulfatide IgM and GM3 IgM positivity in the CSF. However, tests for autoantibodies of CDK4 the nodes of Ranvier and the COVID-19 polymerase chain reaction test results were negative. Other blood test results were normal, including thyroid function; connective tissue and vasculitis screening; a rheumatic and neoplastic-related examination; and blood glucose, vitamin B12, and folic acid levels. The only positive result was found for anti-nuclear antibodies. Brain magnetic resonance imaging (MRI) findings were unremarkable and did not show any evidence of cranial nerve hypertrophy (Figure 1). The patients electromyography results.