小结
定义
病史和体格检查
关键诊断因素
- 疾病进展
- 虚弱
- 感觉改变
- 深部腱反射减弱
其他诊断因素
- 共济失调
- 40 至 60 岁
- 近期感染
- 未接触引发神经病的药物
- 呼吸困难
- 面部无力
- 构音障碍
- 吞咽困难
- 尿失禁
- 尿急或排尿踌躇
- 阳痿
- 体位性低血压
- 视神经乳头水肿
- 视力丧失
- 痉挛状态
危险因素
- 男性
- 自身免疫性疾病
- 糖尿病
- 感染
- 未定性的单克隆丙种球蛋白病 (MGUS)
诊断性检查
首要检查
- 神经传导检查
需考虑的检查
- 脑脊液 (CSF) 评估
- 神经超声
- 脊柱和神经丛 MRI（平扫和增强）
- 临床治疗尝试
- 神经活检
- 酶联免疫吸附测定 (ELISA) 或蛋白质印迹法检测自身抗体
- 其他检查
治疗流程
对功能和生活质量未产生重大影响
对功能和生活质量产生重大影响
对初步单药治疗局部反应或无反应
对 2 种初始药物的联合治疗无反应
对治疗产生反应
对治疗无反应
撰稿人
作者
Karissa L. Gable, MD
Associate Professor of Neurology
Department of Neurology
Duke University School of Medicine
Durham
NC
利益声明
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
Durham
NC
利益声明
TW is an author of references cited in this topic.
鸣谢
Dr Karissa L. Gable and Dr Thapat Wannarong would like to gratefully acknowledge Professor Glenn Lopate, the previous contributor to this topic.
利益声明
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.
同行评议者
Anza B. Memon, MD
Senior Staff Neurologist
Henry Ford Health System
Clinical Assistant Professor
Wayne State University School of Medicine
Detroit
MI
利益声明
ABM declares that she has no competing interests.
Richard A.C. Hughes, MD, FRCP, FMedSci
Professor
Cochrane Neuromuscular Disease Group
MRC Centre for Neuromuscular Disease
National Hospital for Neurology and Neurosurgery
London
UK
利益声明
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
Professor
CHU Dupuytren
Service et Laboratoire de Neurologie
Limoges
France
利益声明
Not disclosed.
鉴别诊断
- 吉兰-巴雷综合征 (GBS)
- 腓骨肌萎缩症 (CMT)
- 抗髓鞘相关糖蛋白（抗 MAG）神经病
更多 鉴别诊断指南
- 欧洲神经病学学会/周围神经学会关于慢性炎症性脱髓鞘性多发性神经根神经病的诊断和治疗指南：联合工作组的报告（第二次修订）
更多 指南
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明