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Chronic inflammatory demyelinating polyneuropathy: Treatment and prognosis

Author
Richard A Lewis, MD
Section Editor
Jeremy M Shefner, MD, PhD
Deputy Editor
John F Dashe, MD, PhD

INTRODUCTION

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an entity that describes a group of related neuropathies, all having chronicity, demyelination, inflammation, and immune-mediation in common.

In the classic form of CIDP, motor involvement is greater than sensory, and neurologic deficits are fairly symmetric. Weakness is present in both proximal and distal muscles. Most patients have globally diminished or absent reflexes. Cranial nerve and bulbar involvement occur in a minority. The clinical course of CIDP is slowly progressive in a majority of patients, but a relapsing-remitting course is noted in at least one-third.

Of major importance, CIDP generally responds to immunomodulatory treatment with glucocorticoids, intravenous immune globulin, or plasma exchange.

The treatment and prognosis of CIDP will be reviewed here. Other aspects of CIDP are discussed separately. (See "Chronic inflammatory demyelinating polyneuropathy: Etiology, clinical features, and diagnosis".)

APPROACH TO TREATMENT

There are some patients with CIDP who have such mild disease with minimal impact on function and quality of life that treatment is not required. However, most patients are significantly impaired by the disorder and need treatment. The mainstays of therapy for CIDP are intravenous immunoglobulin (IVIG), glucocorticoids, and plasma exchange. (See 'Initial therapy and ongoing therapy' below and 'Intravenous immune globulin' below and 'Glucocorticoids' below and 'Plasma exchange' below.)

                 

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Literature review current through: Nov 2016. | This topic last updated: Tue Mar 15 00:00:00 GMT+00:00 2016.
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