Today's post from nlm.nih.gov (see link below) may confuse some readers; partly because there are just way too many names for neuropathic conditions but also because they're not sure if their symptoms are 'bad' enough to qualify as having chronic inflammatory neuropathy. This article describes what it is, what the symptoms are and why it happens, as well as showing some tests and assessments. The main difference lies in the cause - the immune system attacks the nervous system and gradually degrades nerves and their linings but after that, the reasons why can be (as you know) many and varied.
US National Library of medicine 2014
Chronic inflammatory polyneuropathy involves nerve swelling and irritation (inflammation) that leads to a loss of strength or sensation.
Causes
Chronic inflammatory polyneuropathy is one cause of damage to nerves outside the brain or spinal cord (peripheral neuropathy). Polyneuropathy means several nerves are involved. It usually affects both sides of the body equally.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is the most common chronic neuropathy caused by an abnormal immune response. CIDP occurs when the immune system attacks the myelin cover of the nerves.
The cause of chronic inflammatory polyneuropathy is an abnormal immune response. The specific triggers vary. In many cases, the cause cannot be identified.
It may occur with other conditions, such as:
Autoimmune disorders
Chronic hepatitis
Diabetes
HIV
Inflammatory bowel disease
Systemic lupus erythematosus
Lymphoma
Paraneoplastic syndrome
Thyrotoxicosis
Side effects of medicines to treat cancer or HIV
Symptoms
Difficulty walking due to weakness or trouble feeling your feet
Difficulty using the arms and hands or legs and feet due to weakness
Sensation changes, such as numbness or decreased sensation, pain, burning, tingling, or other abnormal sensations (usually affects the feet first, then the arms and hands)
Weakness, usually in the arms and hands or legs and feet
Other symptoms that can occur with this disease:
Abnormal movement
Breathing difficulty
Fatigue
Hoarseness or changing voice
Loss of function or feeling in the muscles
Muscle atrophy
Muscle contractions
Speech impairment
Swallowing difficulty
Uncoordinated movement
Exams and Tests
The doctor will examine you and ask questions about your medical history. The physical exam shows:
Loss of muscle mass
No reflexes
Muscle weakness or paralysis
Sensation problems on both sides of the body
Tests may include:
Electromyography (EMG)
Nerve conduction tests
Nerve biopsy
Spinal tap
Blood tests may be done to look for specific proteins that are causing the immune attack on the nerves
Which other tests are done depends on the suspected cause of the condition. Tests may include x-rays, imaging scans, and blood tests.
Treatment
The goal of treatment is to reverse the attack on the nerves. In some cases, nerves can heal and their function can be restored. In other cases, nerves are badly damaged and cannot heal, so treatment is aimed at preventing the disease from getting worse.
Which treatment is given depends on how severe the symptoms are, among other things. The most aggressive treatment is usually only given if you have difficulty walking or if symptoms interfere with your ability to care for yourself or perform work functions.
Treatments may include:
Corticosteroids to help reduce inflammation and relieve symptoms
Other medications that suppress the immune system (for some severe cases)
Plasmapheresis or plasma exchange to remove antibodies from the blood
Intravenous immune globulin (IVIg), which involves adding large numbers of antibodies to the blood plasma to reduce the effect of the antibodies that are causing the problem
Outlook (Prognosis)
The outcome varies. The disorder may continue long term, or you may have repeated episodes of symptoms. Complete recovery is possible, but permanent loss of nerve function is not uncommon.
Possible Complications
Pain
Permanent decrease or loss of sensation in areas of the body
Permanent weakness or paralysis in areas of the body
Repeated or unnoticed injury to an area of the body
Side effects of medications used to treat the disorder
When to Contact a Medical Professional
Call your health care provider if you have a loss of movement or sensation in any area of the body, especially if your symptoms get worse.
Alternative Names
Polyneuropathy - chronic inflammatory; CIDP; Chronic inflammatory demyelinating polyneuropathyPolyneuropathy - chronic inflammatory; CIDP; Chronic inflammatory demyelinating polyneuropathy
References
Katirji B, Koontz D. Disorders of peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds.Katirji B, Koontz D. Disorders of peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 76.
Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds.Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 428.
Update Date 7/27/2014
Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
https://www.nlm.nih.gov/medlineplus/ency/article/000777.htm
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