Chronic Inflammatory Demyelinating Polyneuropathy
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neurological disorder that is characterized by gradually increasing sensory loss and weakness associated with the loss of deep tendon reflex in the legs and arms.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a progressive motor and sensory neuropathy which is very painful and debilitating.
The axon (nerve fiber) works like an electric wire. The myelin sheath around the axon is the insulation that is necessary for the nerve to conduct electrical impulses properly.
In chronic inflammatory demyelinating polyneuropathy (CIDP), myelin is attacked through very complex mechanisms. In such cases, the body sees the peripheral nerve as foreign and antibodies bind to the myelin and initiate to break it down.
For example, if you are willing to move your finger, messages tell your brain to move the finger. Then electrical communication inside your body tells your nerves and muscles to move the finger. When there is disruption in the myelin sheath, those messages are weakened.
Your brain is telling your finger to move but the nerves are damaged and the movement is weakened, delayed, or absent. When the myelin sheath is completely ruptured, the message is blocked and this is called paralysis.
However, a neurologist that has experience in this type of disease should be able to identify the gradual symptoms and rule out any other cause. Typically, a diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) is based on the person’s symptoms. Common symptoms in chronic inflammatory demyelinating polyneuropathy (CIDP) patients include:
- Loss of deep tendon reflex
- Foot drop
- Difficulty walking (altered gait, stumbling)
In addition to the symptoms, tests like a nerve conduction study (NCS) and electromyography (EMG) – a diagnostic procedure to assess the health of muscles and the nerve cells that control them can be administered to determine the extent of demyelinating disease.
In this disease, there is a damage done to the lining of the nerves that are important for electrical nerve conduction. This can be confirmed by EMG studies or nerve biopsy. A nerve biopsy is done to affirm the inflammatory process in patient’s nerve.
A spinal fluid analysis is another diagnostic test that helps determine if a patient has elevated protein with normal cell count, an abnormality found in chronic inflammatory demyelinating polyneuropathy (CIDP) patients.
At the end, your doctor may perform blood and urine tests to extract other diseases that may cause neuropathy, like diabetes, which is the number cause of peripheral neuropathy.
The therapy for chronic inflammatory demyelinating polyneuropathy (CIDP) includes these three primary protocols:
- IVIG (intravenous immunoglobulin is used to treat many autoimmune, infectious, and idiopathic diseases) – can aggravate kidney dysfunction, cardiovascular disease, cerebrovascular disease, and other.
- Corticosteroids (oral prednisone, pulse oral dexamethasone, IV methylprednisolone) – often improve strength, are conveniently taken by mouth, and are inexpensive. Side effects, however, can limit long-term use.
- Plasma exchange – It is a process through which some of the patient’s blood is extracted and the blood cells returned without the liquid plasma portion of the patient’s blood. It may work by removing harmful antibodies present in the plasma. Short-term relief.
If treated early, most chronic inflammatory demyelinating polyneuropathy (CIDP) people respond well to therapy that can reduce the damage to peripheral nerves and contribute to improved function and quality of life.
If left untreated, 30% of chronic inflammatory demyelinating polyneuropathy (CIDP) patients will progress to wheelchair dependence.