# Chronic Inflammatory Demyelinating Polyneuropathy Following Lumbar Spine Surgery in a Patient With Sarcoidosis

## TL;DR

A 61-year-old man with sarcoidosis developed CIDP after lumbar spine surgery, highlighting the rare but important link between these conditions.

## Contribution

This case report adds to the understanding of CIDP's association with sarcoidosis and its potential post-surgical onset.

## Key findings

- The patient developed CIDP symptoms four hours after lumbar spine surgery.
- MRI showed no acute changes, but EMG confirmed axonal neuropathy consistent with CIDP.
- Treatment with intravenous immune globulin led to symptom improvement.

## Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare relapsing-remitting autoimmune polyneuropathy that targets peripheral nerves and has been associated in the literature with sarcoidosis. The goal of this study is to report the clinical case of a 61-year-old man with sarcoidosis who developed CIDP following lumbar spine surgery. The patient presented at their clinic visit with lumbar back pain and underwent a dome laminoplasty at L2-3, L3-4, and L4-5 with no known complications. Approximately four hours postoperatively, he developed bilateral lower extremity weakness most prominent along the tibialis anterior and extensor hallucis longus (L4-S1) as well as saddle anesthesia. An MRI revealed no acute changes concerning compression. Electromyography (EMG) was performed six months postoperatively, which revealed absent F waves along the peroneal and tibial nerves as well as decreased amplitude consistent with an underlying axonal neuropathy. He was referred to a neurologist for a second opinion where a diagnosis of CIDP was made. Intravenous immune globulin treatment was initiated, and the patient felt improvement in his symptoms. This case highlights the association between sarcoidosis and CIDP and discusses the pathophysiology of the disease. In patients with sarcoidosis and weakness following lumbar surgery with a negative MRI, CIDP should be on the differential.