Chronic inflammatory demyelinating polyneuropathy (CIDP) affects a person’s ability to move, especially their arms and legs, as well as their sensory functions, which can lead to tingling and numbness.
The disorder is rare, occurring in around 5 to 7 per 100,000 people in the United States, according to the National Organization for Rare Disorders.
What causes CIDP?
It is believed that CIPD is caused by the body attacking the myelin sheaths that protect nerves, causing inflammation.
Although doctors do not know the exact cause of CIDP, they believe the condition is an autoimmune disorder where the body’s defense systems attack healthy tissues.
In the case of CIDP, these healthy tissues are the myelin sheaths that protect nerves and enable the nervous system to transmit signals more quickly.
The condition also causes inflammation in the nerves.
Difference to other disorders
While the disease has some similarities to other neurological disorders, such as Guillain-Barre syndrome (GBS) and multiple sclerosis (MS), there are several differences regarding onset, symptoms, and treatment course.
For example, a person with GBS can often identify an infection that occurred before their symptoms began, such as mononucleosis. Those with CIDP cannot usually identify a preceding infection.
A person with CIDP usually has symptoms that may continue for about 8 weeks, which is twice as long as typical GBS symptoms last for. Another difference is that GBS is an acute disorder that will not typically recur while CIDP symptoms may be ongoing.
Some doctors consider CIDP a chronic form of GBS.
Symptoms associated with CIPD tend to be progressive. Some of the condition’s potential symptoms include:
- difficulty swallowing (dysphagia)
- double vision
- foot drop
- loss of reflexes
- numbness in the hands or feet
- tingling or pain in the extremities
- unexplained fatigue
The condition’s symptoms tend to occur on both sides of the body, for example, in both legs. Some people may only notice changes in sensory function, such as tingling and numbness, without experiencing changes in their walking or movement.
What are the treatment options?
Intravenous medication may be prescribed to treat the symptoms of CIPD.
Treatment for CIDP involves trying to reduce the inflammation that causes the nerve-related symptoms. Although there is no cure for this condition, medications that modulate or normalize the immune system can help improve the effects that CIDP has on a person’s nerves.
The United States Food and Drug Administration (FDA) recently approved two drugs to treat CIDP. The drugs decrease the immune system activity that causes nerve-related symptoms.
Both are in the IVIg class (intravenous immunoglobulin). One of the drugs is Gamunex; the other is Privigen. Both drugs contain antibodies (immunoglobulins) that help prevent other immunoglobulins from damaging nerves in CIDP.
While these medications can help to reduce inflammation in CIDP, they do not cure it.
A doctor may also prescribe medications known to suppress the immune system (immunomodulators), which can also improve signs and symptoms of CIDP. These include:
Another effective option to treat CIDP is plasma exchange or plasmapheresis. This procedure involves removing some of a person’s blood and separating the red blood cells and other blood components, such as antibodies, from the plasma that contribute to CIDP. Donor plasma is then added to the blood and transfused back into the individual.
Some medicines can help the symptoms of CIDP without modulating the immune system or decreasing inflammation.
These drugs can be given alongside the immunomodulators mentioned above. They include:
A persons reflexes may be tested to diagnose CIPD, as the condition can affect reflex time and limb strength.
CIDP is a rare condition, so doctors may have difficulty in initially diagnosing it. Because the symptoms are often progressive, a doctor may need to monitor an individual over the course of 1 to 2 months before being clear about the diagnosis.
The doctor will begin by taking a medical history and asking the person about symptoms. Some symptoms that may indicate CIDP include the absence of reflexes and weakness in the arms and legs.
After considering a person’s symptoms, a doctor will likely order a range of tests to rule out other similar disorders. For example, a doctor may recommend a lumbar puncture to test spinal fluid for the presence of inflammatory cells, such as white blood cells. Meningitis and nervous system cancer can also cause a range of symptoms that are similar to CIDP.
A doctor may also order tests to measure how well a person’s nerves are conducting electrical signals. These tests include nerve conduction testing and electromyography. If a person’s nerves are not conducting as quickly as expected, this could support a diagnosis of CIDP.
People respond differently to CIDP treatments. Some may see an improvement in immune system function; others may see many of their symptoms resolve, while others may not experience any improvement in their symptoms.
Can diet help treat CIDP?
Sometimes doctors will recommend an anti-inflammatory diet for those with CIDP as a means to potentially reduce their symptoms. However, diet is no substitute for the medications listed above.
An anti-inflammatory diet has many of the same characteristics as most healthful diets, in that a person should avoid:
- high-sodium foods
- high-sugar foods
- processed foods
- saturated fats
- trans fats
A person with CIDP should eat a predominantly plant-based diet filled with colorful fruits and vegetables. Other foods that a person with CIDP should eat include lean meats and fatty, low-mercury fish, such as salmon.
Dietary recommendations may vary according to an individual’s additional health conditions or unique dietary preferences.
Those treated for CIDP often experience an improvement in symptoms, then a series of relapses. According to a study published in the journal Current Treatment Options in Neurology, an estimated 90 percent of people with CIDP will respond to immunosuppressive treatments, such as IVIg.
However, in the long-term, many people with CIDP eventually require assistive devices, such as canes, walkers, or wheelchairs to help them move around. As a general rule, the earlier a person is diagnosed and treated for CIDP, the better their prognosis tends to be.
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