MRI-negative combined central and peripheral demyelination involving a spinal cord with anti-lactosylceramide antibody.

Combined central and peripheral demyelination (CCPD) is a rare neurological disorder affecting both the central and peripheral nervous systems, and its clinical features have yet to be fully characterized. Conventionally, MRI abnormalities have been used to identify central nervous system involvement in CCPD. We herein describe a patient who developed demyelinating peripheral neuropathy after being diagnosed with MRI-negative myelopathy and thereafter was definitively diagnosed with CCPD. The cerebrospinal fluid test was positive for anti-lactosylceramide antibodies, which are associated with CCPD. This study highlights the need to be aware of MRI-negative CCPD and encourages the active investigation of relevant antibodies to advance both understanding and treatment.