Chronic inflammatory polyneuropathy
Chronic inflammatory polyneuropathy involves nerve swelling and irritation (inflammation) that leads to a loss of strength or sensation.
Polyneuropathy - chronic inflammatory; CIDP; Chronic inflammatory demyelinating polyneuropathy
Causes, incidence, and risk factors
Chronic inflammatory polyneuropathy leads to a common type 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 the same amount.
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:
- Difficulty walking due to weakness
- Difficulty using the arms and hands or legs and feet due to weakness
- Facial weakness
- Sensation changes (usually affects 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:
Signs 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
- Sensation problems on both sides of the body
Tests may include:
Which other tests are done depends on the suspected cause of the condition, and may include x-rays, imaging scans, and blood tests.
The goal of treatment is to control symptoms. What 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)
- Removing antibodies from the blood, using plasmapheresis or plasma exchange
- 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
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.
- 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
Calling your health care provider
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.
Shy ME. Peripheral neuropathies. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 446.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.