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Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neurological disorder that causes damage to nerves in the peripheral nervous system, or nerves outside the brain and spinal cord. Oftentimes, the cause of this disorder cannot be determined, though it has been associated with HIV, chronic active hepatitis, lupus erythematosus, blood cell disorders, and inflammatory bowel disease. The most common symptoms of chronic inflammatory demyelinating polyneuropathy include muscle fatigue, abnormal sensation, pain or tingling, progressive loss of reflexes, muscle weakness and eventual flaccid paralysis, especially in the arms or legs.
Chronic inflammatory demyelinating polyneuropathy is believed to occur when the immune system fails to recognize the peripheral nerves and begins to attack them. In particular, the immune cells attack the myelin sheath. Myelin is a fatty covering that surrounds the axons on neurons and helps conduct nerve impulses quickly from neuron to neuron. When this is taken away, or the neurons are demyelinated, it causes the nerves to respond weakly, or not at all. Because the disorder affects several nerves it is called polyneuropathy, and its chronic, or gradual, nature differentiates it from related, acute diseases such as Guillan Barré syndrome.
CIDP is fairly rare. It tends to affect men more than women, and is most common in young adults. Though some people with CIDP may be able to wait it out and let the symptoms go away on their own, most people with CIDP will never get relief from the symptoms without treatment.
Symptoms of chronic inflammatory demyelinating polyneuropathy typically begin with gradual weakening and loss or change of sensation in the arms and legs. Symptoms can progress to include facial weakness, trouble walking, issues with bowel and bladder control, joint pain, muscular atrophy, difficulty swallowing, difficulty controlling movements, trouble breathing, facial paralysis, and hoarseness. A physician might conduct an electromyography (EMG) exam, a nerve conduction velocity (NCV) test, nerve biopsy, a spinal tap, and X-ray to determine whether CIDP is the cause of these symptoms.
Treatments for chronic inflammatory demyelinating polyneuropathy usually deal with taming the immune system. Neurologists and immunologists often prescribe corticosteroids and other immunosuppressants to hold the immune response at bay. Plasmapheresisis another common treatment. During this procedure, doctors remove the plasma from the body, remove immune proteins called antibodies from the plasma, and then return the plasma to the body. Doctors may also use intravenous immunoglobulin (IVIG), a donated plasma product administered into the bloodstream, to prevent the immune system from causing inflammation where it’s not supposed to. Physical therapy can help retrieve lost muscle function, but for many CIDP patients, some sensation and muscle loss will be permanent.