Managing the diagnostic challenge: chronic inflammatory demyelinating polyneuropathy during pregnancy

Chronic inflammatory demyelinating polyneuropathy (CIDP) during pregnancy presents diagnostic and management challenges. We report a case of a primigravida in her 30s, exhibiting progressive quadriparesis starting in the second trimester. Initially, her symptoms of weakness, numbness and progressive quadriparesis were attributed to vitamin B12 deficiency, leading to the administration of intramuscular methylcobalamin injection. After referral to our tertiary care centre at 37 weeks of pregnancy and after further evaluation, neurological examination revealed findings characteristic of CIDP, which were confirmed by nerve conduction studies showing typical features of the condition. Treatment included intravenous methylprednisolone followed by intravenous immunoglobulin. An elective caesarean section was carried out because the patient was unable to effectively participate in labour due to her condition. The patient exhibited improved limb power postoperatively after immunoglobulin therapy. Challenges include delayed diagnosis, treatment initiation and management decisions. Multidisciplinary collaboration is crucial for optimal outcomes in CIDP during pregnancy.