Abstract Details

Title Atypical Presentation of Chronic Inflammatory Demyelinating Polyneuropathy and Comorbid Psychiatric Disorders

Topic Autoimmune Neurology

Presentation(s) P2 - Poster Session 2 (2:45 PM-3:45 PM)

Poster/Presentation
Number 041

Objective A 28-year-old female presented with acute onset suicidal ideation and was admitted to the psychiatric inpatient service. She was found to have a complex past psychiatric history including major depressive disorder, borderline personality disorder, and obsessive-compulsive disorder alongside two prior suicide attempts with hospitalizations. Her medical history includes chronic inflammatory demyelinating polyneuropathy, a below-knee amputation on the right leg, recurrent wound infections, Charcot foot, and peripheral artery disease. A thorough assessment revealed that her history of CIDP and its ensuing complications, specifically the active wound infections at the site of her BKA and limited mobility necessitating an assistive device, were significantly exacerbating her psychiatric symptoms and acting as a major impediment to her treatment. This case underscores the interplay between her neurologic and psychiatric conditions, highlighting the necessity of an integrated treatment approach. In response to her complex needs, the treatment plan was tailored to address mood symptoms, sleep dysfunction, and chronic pain, which had been poorly managed. This included an increase in lamotrigine dosage from 50 to 75 mg daily, the introduction of trazodone at 100-150 mg nightly to aid sleep, and the addition of gabapentin 300 mg three times daily for neuropathic pain. Furthermore, her regimen of fluoxetine HCL at 60 mg daily was continued. Remarkably, within four days of initiating treatment, the patient exhibited a complete resolution of suicidal ideation and notable enhancements in mood, sleep quality, and pain management. This case presentation highlights the atypical presentation of CIDP in a young female, elaborating on the challenges posed by a progressive case of CIDP and its exacerbation of existing psychiatric symptoms. This case provides valuable insights into the intersection of immuno-neurological and psychiatric disorders, advocating for a holistic, biopsychosocial approach to patient care that addresses the full spectrum of their needs.

Background NA

Design/Methods NA

Results NA

Conclusions NA

Authors/Disclosures
Seema Arshed PRESENTER	Ms. Arshed has nothing to disclose.
Arazoo Shwany	Ms. Shwany has nothing to disclose.
Patrick T. Brain, DO Student	Mr. Brain has nothing to disclose.

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