• Progression over at least two months
• Weakness more than sensory symptoms
• Symmetric involvement of arms and legs (the same symptoms on both sides)
• Proximal muscles (those closer to the trunk) involved along with distal muscles (those further from the trunk)
• Reduced deep tendon reflexes throughout (found by the clinician "tapping" the knee, outside of the elbows, crooks of the arms, wrists and ankles)
• Increased cerebrospinal fluid protein without pleocytosis (an increased cell count)
• Nerve conduction evidence of a demyelinating neuropathy
• Nerve biopsy evidence of segmental demyelination (degeneration of the myelin sheath with sparing of the axon) with or without inflammation

• intravenous immune globulin (IVIG) - adds large numbers of antibodies to the blood plasma to reduce the effect of the antibodies that are causing the problem
• glucocorticoids - help reduce inflammation and relieve symptoms
• plasma exchange - removes harmful antibodies from the blood

• IVIG and plasma exchange may lead to a more rapid improvement in CIDP than glucocorticoid therapy, but are less likely than glucocorticoids to produce a remission
• IVIG is expensive, and its supply is sometimes limited
• Glucocorticoids are inexpensive, but chronic use is limited by common and important side effects
• Plasma exchange is expensive, invasive, and available only at specialized centers

What is chronic inflammatory demyelinating polyneuropathy (CIDP)?

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neurological disorder characterized by progressive weakness and impaired sensory function in the legs and arms. The disorder, which is sometimes called chronic relapsing polyneuropathy, is caused by damage to the myelin sheath (the fatty covering that wraps around and protects nerve fibers) of the peripheral nerves. Although it can occur at any age and in both genders, CIDP is more common in young adults, and in men more so than women. It often presents with symptoms that include tingling or numbness (beginning in the toes and fingers), weakness of the arms and legs, loss of deep tendon reflexes (areflexia), fatigue, and abnormal sensations. CIDP is closely related to Guillain-Barre syndrome and it is considered the chronic counterpart of that acute disease.

Is there any treatment?

Treatment for CIDP includes corticosteroids such as prednisone, which may be prescribed alone or in combination with immunosuppressant drugs. Plasmapheresis (plasma exchange) and intravenous immunoglobulin (IVIg) therapy are effective. IVIg may be used even as a first-line therapy. Physiotherapy may improve muscle strength, function and mobility, and minimize the shrinkage of muscles and tendons and distortions of the joints.

What is the prognosis?

The course of CIDP varies widely among individuals. Some may have a bout of CIDP followed by spontaneous recovery, while others may have many bouts with partial recovery in between relapses. The disease is a treatable cause of acquired neuropathy and initiation of early treatment to prevent loss of nerve axons is recommended. However, some individuals are left with some residual numbness or weakness.