CIDP

(Chronic Inflammatory Demyelinating Polyneuropathy)

 Introduction
• Chronic Inflammatory Denyelinating Polyneuropathy (CIDP) is
a chronic, acquired, immune-mediated condition affecting the
peripheral nervous system
• CIDP is rare autoimmune disorder characterized by
progressive peripheral neuropathy
• Guidelines for the diagnosis and treatment of CIDP have been
developed, the large variety of clinical and
electrophysiological variants, associated systemuc conditions,
and lack of sustained improvement with standard treatments
in up to one third of cases provide challenges to the clinician
in practice
• It is treatable in the majority of the cases
• Numerous clinical trials have establish the short-term efficacy
of immune therapies such as corticosteroids, plasma exchange
(PE), and introvebous immune globulin (IVIg)
 CIDP vs GBS
• CIDP is distinguish from
acute inflammatory CIDP GBS
demyelinating Time course Polyphasic Monophasic
polyradiculopathy (remission
(AIDP), the most and relap)
common form of Antibody Unclear Identified
Guillain-Barre Syndrome
(GBS), by time course Severity of clinical Less Severe
and steroid symptom
responsiveness Response to Yes No
• CIDP typically responds steroid
to corticosteroid therapy,
whereas AIDP does not
 Clinical features of CIPD (Joint Task
Force of The EFNS And PNS, 2010)

Progressive symmetrical or asymmetrical polyradiculopathy

Relapsing or progressive course >2 months

Proximal weakness usually prominent

Large fiber sensory loss in the distal limbs (vibration and joint position sense)

Generalized hypo-reflex or areflex

Clinical & Electrodiagnostic Criteria
Inclusion Criteria
Exclusion Criteria
Typical CIDP Atypical CIDP
- Chronic progressive, -Predominantly - Infection, drug/ toxin
stepwise, or distal - Hereditary
recurrent symmetric - Asymmetric - Sphincter distrubance
prox & distal - Focal - Diagnosis of MMN
weakness & sensory - Pure motor - IgM monoclonal gammanopathy
dysfunction all - Pure Sensory - Other demyelinating neruopathy
extremities
- ±2 months durations
- Cranial nerve
affected
- Tendon reflexes
absent/ reduced in
all extremities
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