Chronic inflammatory demyelinating polyneuropathy : Current Opinion in Neurology

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NERVE, NEURO-MUSCULAR JUNCTION AND MOTOR NEURON DISEASES: Edited by Jean-Marc Léger

Chronic inflammatory demyelinating polyneuropathy

Lewis, Richard A.

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Current Opinion in Neurology 30(5):p 508-512, October 2017. | DOI: 10.1097/WCO.0000000000000481

Abstract

Purpose of review 

As a syndrome with typical and atypical cases, chronic inflammatory demyelinating polyneuropathy (CIDP) has been a difficult disorder to diagnose and treat. The pathophysiologic basis for CIDP has not been established, contributing to the challenges in dealing with these patients. However, as one of only a handful of treatable peripheral neuropathies, there has been a tendency to diagnose CIDP to attempt a therapeutic intervention. We are also aware that there has also been overtreatment of some patients. This combination of overdiagnosis and prolonged treatment has been a concern. This chapter will review these challenges and discuss recent findings that will lead to improved diagnosis and treatment.

Recent findings 

The factors leading to misdiagnosis of CIDP were explored in a cohort of patients referred to a neuromuscular center. On a more positive note, the identification of two disorders with antibodies directed at paranodal constituents has excited the field. Treatment options have increased and been clarified. Pulse corticosteroids have been compared with oral prednisone and with intravenous immunoglobulin. The clinical trial of subcutaneous immunoglobulin in CIDP has shown both efficacy and a very low side effect profile adding to our therapeutic options.

Summary 

The current review will identify recent developments that show both the challenges and the exciting growth in our ability to diagnose and treat CIDP.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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