(Chronic acquired demyelinating polyneuropathy, chronic relapsing polyneuropathy)
The chronic inflammatory demyelinating polyneuropathy is an immune-mediated polyneuropathy, which is characterized by symmetrical weakness of proximal and distal muscles and through a progression that has lasted> for 2 months.
(Further see overview of disorders of the peripheral nervous system.)
The chronic inflammatory demyelinating polyneuropathy is an immune-mediated polyneuropathy, which is characterized by symmetrical weakness of proximal and distal muscles and through a progression that has lasted> for 2 months. (Further see overview of disorders of the peripheral nervous system.) The symptoms of chronic inflammatory polyneuropathy demyelinisierendne (CIDP) are similar to those of Guillain Barre syndrome. However CIDP is different in the progression over> 2 months from Guillain-Barre syndrome, which is single-phase and self-limiting. A CIDP develops in 3-10% of patients with Guillain-Barre syndrome. Symptoms and complaints CIDP begins insidiously generally and may deteriorate slowly or follow a pattern of relapses and recovery; the recovery can be partially or completely between relapses. Flaccid paralysis, usually in the extremities, dominated in most patients; it is the sensory disturbances compared to typically in the foreground (z. B. paraesthesia of the hands and feet), the tendon reflexes fail. In most patients, the autonomic function is less affected than the Guillain-Barre syndrome, although weakness may be asymmetrical and may progress more slowly than in Guillain-Barre syndrome. Diagnostic CSF analysis and electro-diagnostic testing The tests include CSF analysis and an electro-diagnostic testing. The results are comparable to those in Guillain-Barre syndrome, incl. Zytoalbuminärer dissociation (increased protein but normal white blood cell count) and demyelination, which is detected using the electro-diagnostic testing. A nerve biopsy with which demyelination can also recognize, is rarely needed. Treatment Intravenous immunoglobulin Plasma exchange Corticosteroids It is often difficult to decide which therapy should be offered first. IVIG is better tolerated than corticosteroids and has fewer side effects, but IVIG may be associated with earlier deterioration after treatment is stopped. Subcutaneous IG can be as effective as IVIG. Plasma exchange is the most invasive of the three options and is therefore finally offered. Immunosuppressants (eg. As azathioprine) can help and reduce dependence on corticosteroids. The treatment may be needed for a long time. Important Points Although the symptoms of CIDP resemble those of Guillain-Barre syndrome, the two can be differentiated on the basis of how long the symptoms continue to progress (d. H.> 2 months for CIDP). The symptoms begin gradually and may worsen slowly or follow a pattern of relapses and recovery. CNS analysis and electro-diagnostic results are similar to those of Guillain-Barre syndrome. Treat with IVIG and corticosteroids, but pull in severe cases, a plasma exchange into account; Immunosuppressants and can help reduce dependence on corticosteroids.