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Intro to Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

What is CIDP?

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a rare disorder of the peripheral nerves characterised by gradually increasing sensory loss and weakness associated with loss of reflexes.

CIDP is caused by damage to the covering of the nerves, called myelin. It can start at any age and is more frequent in men than women.

Many people with CIDP benefit with treatment. Although there is a wide spectrum of how severely people with CIDP can be affected, some with the condition require assistance to perform daily tasks. In the more severe cases, devices like wheelchairs or walkers may be needed for mobility. One of the goals of early diagnosis and proper treatment is to avoid this level of disability and to improve the long-term outlook.

Frequently Asked Questions

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a rare disorder of the peripheral nerves characterised by gradually increasing sensory loss and weakness associated with loss of reflexes.

CIDP is caused by damage to the covering of the nerves, called myelin. It can start at any age and is more frequent in men than women.

Many people with CIDP benefit with treatment.  Although there is a wide spectrum of how severely people with CIDP can be affected, some with the condition require assistance to perform daily tasks. In the more severe cases devices like wheelchairs or walkers may be needed for mobility. One of the goals of early diagnosis and proper treatment is to avoid this level of disability and to improve the long term outlook.

CIDP is caused by an autoimmune response in which the body’s immune system mistakenly attacks the myelin sheath that surrounds peripheral nerves. This leads to nerve inflammation and damage, which disrupts the signals between the nerves and muscles. The exact trigger isn’t fully understood, and there is no single known cause, though infections, genetics, or other immune system factors may play a role.

CIDP is diagnosed through a combination of clinical evaluation, electromyography (EMG) and nerve conduction velocity (NCV) testing to detect demyelination, and often a lumbar puncture to check for elevated spinal fluid protein. In some cases, an MRI or nerve biopsy sometimes used to confirm the diagnosis in unclear cases.

There’s no known cure yet, but many people improve significantly with treatment. Some may achieve sustained remission, while others may have ongoing symptoms or relapsing and remitting disease. Recovery varies by individual — early treatment and good response tend to improve the long-term outlook.

There are three standard or first line treatments in CIDP:

  • High-dose Intravenous Immune Globulins (IVIG) contains naturally occurring antibodies obtained from healthy volunteers. IVIG is given through a vein over the course of several hours. There are also newer treatments with preparations of higher concentrations that can be given under the skin (subcutaneous) now available for CIDP patients.
  • Corticosteroids (Prednisone, Prednisolone) are similar to naturally occurring anti-inflammatory hormones made by the body, and can be used as an initial treatment. Corticosteroids often improve strength, are conveniently taken by mouth, and are inexpensive. Side effects however can limit long-term use.
  • Plasma Exchange (PE), or Plasmapheresis (PLEX), is a process by which some of the patient’s blood is removed and the blood cells returned without the liquid plasma portion of the patient’s blood. It may work by removing harmful antibodies contained in the plasma.

Treatment of CIDP is an art. An experienced doctor is more likely to have good outcomes than someone treating their first case as is true throughout medicine. If treated early, most CIDP patients respond well to therapy that can limit the damage to peripheral nerves and contribute to improved function and quality of life and at times can cure the disorder altogether.

CIDP differs from GBS in that CIDP is a chronic condition with symptoms that develop over time and may relapse or go into remission, often requiring ongoing treatment, while GBS is an acute condition that typically progresses rapidly and then improves after a single episode.

The most common treatments for CIDP include intravenous immune globulin (IVIG), corticosteroids such as prednisone, and plasma exchange (plasmapheresis), with treatment plans tailored by a neurologist based on individual response.

CIDP is often chronic, so many people require ongoing or maintenance therapy to control symptoms and prevent nerve damage. The duration of treatment depends on individual response; some may be able to reduce or stop therapy over time under medical supervision.

Always seek advice from a qualified medical professional before making decisions about your health or treatment.

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info@gbs-cidp.co.za

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