Chronic inflammatory demyelinating polyradiculoneuropathy

Summary

  • An acquired demyelinating peripheral neuropathy of presumed autoimmune aetiology.
  • Proximal symmetrical weakness is present in most patients. Atypical cases often have proximal asymmetrical weakness.
  • Nerve conduction studies are the main diagnostic tool, but lack sensitivity; treatment should not be withheld if electrodiagnostic criteria are not met and symptoms are consistent with the diagnosis.
  • Treatment includes intravenous immunoglobulin (IVIG), corticosteroids, and plasma exchange; long-term immunosuppressive therapy may be needed to prevent relapse. Lack of at least a partial response to 1 or 2 first-line agents should cast doubt on the diagnosis.
  • Differentiation from Guillain-Barre syndrome (GBS) is important because corticosteroids may worsen patients with GBS.
Last updated: May 10, 2013
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