CIDP

Lewis-Sumner Syndrome (LSS): This variant, known as multifocal acquired demyelinating sensory and motor neuropathy (MADSAM), features asymmetric weakness and sensory loss in a multifocal distribution, meaning specific areas are affected rather than a symmetric pattern.

Distal Acquired Demyelinating Symmetric (DADS): This variant predominantly involves the distal limbs with more sensory than motor impairment.

Pure Sensory CIDP: This variant Involves predominantly sensory symptoms with minimal or no motor involvement.

Pure Motor CIDP: Characterized by motor symptoms without significant sensory symptoms. This variant can sometimes be difficult to distinguish from Multifocal Motor Neuropathy (MMN).

Because CIDP is rare, it can be challenging to diagnose correctly, especially initially. Healthcare providers may initially suspect Guillain-Barré Syndrome (GBS) due to their similarities. If a person experiences symptoms for a period longer than 8 weeks, their healthcare provider may suspect CIDP.

To confirm a diagnosis, healthcare providers will gather the patient’s medical history and perform a physical exam. Additional tests may include:

• Neurological exam:  These tests include an evaluation of your muscle strength, reflexes and coordination.
• Blood and urine tests
• Nerve conduction study: This test, sometimes called an electromyogram, uses low electrical currents to assess nerve function and detect myelin damage in peripheral nerves.
• Lumbar puncture: In this procedure, a small needle is inserted into the back to withdraw a sample of cerebrospinal fluid (CSF), the fluid surrounding the spinal cord. This test helps detect elevated levels of specific proteins related to CIDP
• MRI: MRI of the lumbar spine with contrast injection to look for enlarged or inflamed nerve roots

Early treatment is crucial in preventing nerve damage and stopping symptoms from becoming severe. Treatment options include:

• Immunoglobulin: Immunoglobulin (Ig) has been shown to modify the autoimmune response that is directed against one’s body tissue. Ig is a product made by taking blood or plasma from 1,000 or more healthy donors and, after mixing them all together, a sophisticated manufacturing process separates them out and purifies the critical antibodies to create Ig.
  • Intravenous Immunoglobulin (IVIG): This treatment entails an IV infusion of immunoglobulin (IVIG) in a hospital or clinic setting.
  • Subcutaneous Immunoglobulin (SCIG): SCIG is self-administered by subcutaneous infusion (SCIG) in which you infuse Ig treatment into the fatty tissue just below your skin’s first layer. SCIG is often prescribed once a patient’s condition has stabilized with IVIG and is done at home.
• Plasma exchange (PE or Plex): Removes and separates plasma from blood cells, potentially eliminating harmful antibodies attacking nerves.
• Corticosteroids: These medications reduce inflammation and slow the immune system.
• Immunosuppressants: These drugs may help stop the immune system from attacking the myelin.
• Stem Cell Transplant: In rare cases, healthy stem cells may be injected to “reset” the immune system.
• If a patient is resistant to traditional CIDP treatments, their healthcare provider may suspect that a different diagnosis should be considered and further diagnostic testing may be ordered.

Physicians might recommend physical therapy for patients to help increase strength and flexibility. Moderate exercise can help patients increase energy levels.

Symptoms of CIDP can fluctuate, sometimes being manageable and other times difficult to cope with. If over-the-counter painkillers are insufficient, medications for pain management may be prescribed.

The course of CIDP can vary greatly between individuals, as can the response to treatment. Early treatment is crucial, offering the best chance to limit symptoms and keep the condition under control. Without treatment, symptoms such as tingling, numbness, weakness, and loss of balance are likely to worsen.

Physical therapy has proven helpful for many patients with physical impairment. Specialists work to maintain or increase strength and improve coordination. Occupational therapy can also be of service to help individuals learn new ways to perform daily tasks despite physical limitations.

Feelings of sadness or depression are common among those with physical disabilities. If a patient experiences these emotions, their healthcare provider may recommend seeing a mental health professional. Antidepressants, psychotherapy, and support groups for people with chronic health conditions can be beneficial.

To manage the stress associated with CIDP, it is recommended that patients consider these suggestions:

•     Maintain a strong support system of friends and family
•     Contact a support group or organization
•     Discuss feelings and concerns with a counsellor