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Chronic inflammatory demyelinating polyradiculoneuropathy

Last reviewed: 30 Oct 2023
Last updated: 31 May 2023



History and exam

Key diagnostic factors

  • disease progression
  • weakness
  • altered sensation
  • decreased deep tendon reflexes
More key diagnostic factors

Other diagnostic factors

  • incoordination
  • age 40 to 60 years
  • preceding infection
  • absence of exposure to neuropathy-causing drugs
  • dyspnea
  • facial weakness
  • dysarthria
  • dysphagia
  • urinary incontinence
  • urinary urgency or hesitancy
  • impotence
  • orthostatic hypotension
  • papilledema
  • vision loss
  • spasticity
Other diagnostic factors

Risk factors

  • male sex
  • autoimmune diseases
  • diabetes mellitus
  • infection
  • monoclonal gammopathy of undetermined significance (MGUS)
More risk factors

Diagnostic investigations

1st investigations to order

  • nerve conduction studies
More 1st investigations to order

Investigations to consider

  • cerebrospinal fluid (CSF) evaluation
  • nerve ultrasound
  • MRI spine and plexus with and without contrast
  • clinical trial of therapy
  • nerve biopsy
  • enzyme-linked immunosorbent assay (ELISA) or Western blot to detect autoantibodies
  • other tests
More investigations to consider

Treatment algorithm


no significant impact on function and quality of life

significant impact on function and quality of life

partial or no response to initial monotherapy

refractory to combination therapy with 2 initial agents


response to treatment

no response to treatment



Karissa L. Gable, MD

Associate Professor of Neurology

Department of Neurology

Duke University School of Medicine




KLG has taken part in CIDP education events for Medscape/Web MD. KLG is an author of references cited in this topic.

Thapat Wannarong, MD

Fellow of Neurology

Department of Neurology

Duke University School of Medicine




TW is an author of references cited in this topic.


Dr Karissa L. Gable and Dr Thapat Wannarong would like to gratefully acknowledge Professor Glenn Lopate, the previous contributor to this topic.


GL is on the medical advisory board for Alnylam Pharmaceuticals and a consultant for Gerson Lehrman Group. GL is an author of references cited in this topic.

Peer reviewers

Anza B. Memon, MD

Senior Staff Neurologist

Henry Ford Health System

Clinical Assistant Professor

Wayne State University School of Medicine




ABM declares that she has no competing interests.

Richard A.C. Hughes, MD, FRCP, FMedSci


Cochrane Neuromuscular Disease Group

MRC Centre for Neuromuscular Disease

National Hospital for Neurology and Neurosurgery




RACH has held or holds consultancies with companies that produce intravenous immunoglobulin (CSL Behring, LFB, Octapharma, Kedrion, and Talecris) and with other companies that produce immunomodulatory drugs (Biogen-Idec and Ares-Serono). RACH has received grants from the UK Department of Health for the Cochrane Neuromuscular Disease Review Group, Sandoz (now Novartis), and Ares-Serono. RACH is an author of a number of references cited in this topic.

Jean-Michel Vallat, MD


CHU Dupuytren

Service et Laboratoire de Neurologie




Not disclosed.

  • Differentials

    • Guillain-Barre syndrome (GBS)
    • Charcot-Marie-Tooth disease (CMT)
    • Anti-myelin-associated glycoprotein (anti-MAG) neuropathy
    More Differentials
  • Guidelines

    • European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force - second revision
    More Guidelines
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