Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

Understanding CIDP

Chronic inflammatory demyelinating polyneuropathy (CIDP) is rare and believed to be an autoimmune disorder. An autoimmune disorder develops when the immune system malfunctions and creates antibodies that attack and cause damage to a part of the body. In CIDP, the myelin sheath is attacked. The myelin sheath is the protective covering over nerves, which aids in transmitting nerve signals from spine to muscles. This attack on the myelin sheath results in muscle weakness and abnormal, or loss of, sensation such as numbness and/or tingling.

Symptoms of CIDP

Symptoms of chronic inflammatory demyelinating polyneuropathy (CIDP) include weakness usually beginning in the legs and then arms. There may be numbness or tingling starting in the feet or hands (stocking-glove pattern) and then traveling upward. The symptoms start and progress slowly over months and even years. CIDP can improve and then worsen again, with or without medication.

Diagnosing CIDP

Diagnosing chronic inflammatory demyelinating polyneuropathy (CIDP) can be difficult and is often a lengthy process. Because symptoms of weakness, numbness and/or tingling can indicate a wide variety of issues, and CIDP is so rare, it is often not at the forefront of a physician's mind as a potential diagnosis. It is after the physician is able to observe the patterns of the symptoms, along with a careful history and other diagnostic workup a diagnosis of CIDP can be made.

Additional diagnostic testing may include:

• Electromyography (EMG) to measure muscle activity.
• Nerve conduction studies (NCS) to measure efficiency and speed of nerve signals.
• Lumbar puncture to assess the spinal fluid for indicators of CIDP, or for other disorders which may cause similar symptoms.
• Blood tests to rule out other conditions which may cause similar symptoms.
• Historically nerve biopsies to look at nerve damage to determine the cause were completed. This is done less routinely now.

Treating CIDP

Treatment of chronic inflammatory demyelinating polyneuropathy (CIDP) may involve steroids, immunosuppressants and/or immune globulin, which can be administered into the blood stream intravenously (IVIG) or under the skin subcutaneously (SCIG). The goal of immune globulin therapy in treating CIDP is to stop the attack on the myelin sheath, which will cause the symptoms to subside. Not all patients respond to immune globulin therapy. For those who do respond, numbness and tingling should decrease and may even stop altogether; strength should increase and tasks that may have become difficult should become easier. Your doctor will assess your response to therapy and determine how long you may need to continue therapy. Some people require short-term therapy to get the maximum benefit while others may require long-term treatment.

Resources:

• American Academy of Neurology
• National Institute of Neurological Disorders and Stroke (NINDS)
• Neurology Muscular Dystrophy and Neuropathy Institute

References:

• GBS/CIDP Foundation International
• Neuropathy Action Foundation
• American Autoimmune Related Diseases Association