Chronic demyelinating polyneuropathy (CIDP) is a neurological disorder that is caused by inflammation of nerves throughout the body. This leads to weakness and changes in sensation.
The fatty, protective coating wrapped around nerves and fibers is called myelin. The damage to the myelin in a person with chronic demyelinating polyneuropathy (CIDP) leads to symptoms such as tingling sensations in your feet and hands, as well as loss of muscle strength.
CIDP is a type of acquired immune-mediated inflammatory disorder. It isn’t contagious, but it’s chronic. Once you develop it, you’ll likely live with symptoms and complications of the disorder for the remainder of your life.
CIDP affects your peripheral nervous system. This includes the nerves outside your brain and spinal cord. Knowing the different symptoms of each disorder and how they progress can help you and a doctor determine which is affecting your body.
CIDP causes weakness, paresthesia, and sensory deficits, usually with recurrent episodes. It affects both sides of the body — in a nearly but not perfectly symmetrical fashion. Symptoms usually develop slowly over a long period of time.
Tingling, burning, and numbness may develop. You may also notice changes to your senses, including loss of taste, decreased sensitivity to touch, and more.
You may notice weakness in your muscles. It can be mild for some but more severe for others. The weakness usually begins more distally (fingers, toes, hands, and feet) and can move closer to the center of the body (upper arms, shoulders, legs, trunk).
Symptoms on both sides
Most people with CIDP will experience symptoms on both sides of their body instead of on just one side. The symptoms on both sides of the body are similar but not identical, and they may or may not occur at the same time or have the same intensity.
For example, you may feel numbness in your left foot and weakness in your left leg, while losing sensation in the right leg.
Symptom onset and progression
Symptoms may increase slowly over the course of several months or even years. The slow progression may not be detectable at first. Some people will live with the symptoms for a long period of time before a diagnosis is finally made. However, some people have a rapid onset of severe symptoms. Many experience recurrent symptoms every few months or every few years.
Doctors and researchers aren’t certain what causes CIDP, but they do know it’s the result of an autoimmune response. The immune system overreacts to a normal, healthy part of the body. It treats the myelin like it treats invading bacteria or viruses and destroys it. For that reason, CIDP is classified as an autoimmune disease.
Many people with CIDP don’t have any identifiable risk factors. Among those who do, the most common risk factors include a history of:
- Guillain-Barré syndrome (GBS)
- viral infection
Some people don’t fully recover after an episode of GBS and can experience the same attack on peripheral myelin for years, but at a lower intensity than during the initial episode. The other factors (cancer, infection, immunization) may trigger an immune response that acts against myelin in the peripheral nervous system.
CIDP is the chronic form of GBS. Like CIDP, GBS is a neurological disorder that causes inflammation of the nerves. This inflammation leads to the destruction of myelin. As the myelin is destroyed, symptoms start to develop.
Symptoms of both conditions develop in a symmetrical pattern, and symptoms of both conditions typically begin in the fingers or toes and work their way in toward bigger muscles.
Neither CIDP nor GBS damages your central nervous system. Neither affects your mental cognition either.
Unlike CIDP, the symptoms of GBS show up quickly and soon reach severe status. Most people will need intensive care if they have GBS. Individuals with CIDP often develop symptoms very slowly. Typically, hospital care is only necessary after the disease has greatly progressed and severely limits daily function.
GBS appears quickly and can just as quickly start to disappear. The lasting effects of the damage may take you several months or years to adjust to, but the symptoms won’t get worse. Also, GBS is unlikely to recur. Only
Most people who receive a GBS diagnosis can point to a recent illness or infection that preceded the inflammatory disorder. Doctors think this infectious or viral illness can wreak havoc on the immune system and cause an unusual response. In the case of GBS, the immune system starts attacking the myelin and nerves.
Unlike CIDP, people with MS develop inflammatory demyelination in the brain and spinal cord. This prevents nerves in these areas from properly transmitting signals, and can cause changes in vision, weakness, sensory loss, fatigue, and brain fog. In severe cases, the nerves become damaged as well.
Symptoms of MS typically affect both sides of the body but aren’t perfectly symmetrical. The symptoms and their severity depend on which areas of the brain or spinal cord are affected.
CIDP is difficult to diagnose. It’s a rare disorder, so doctors may rule out more common diseases or disorders first before they reach a CIDP diagnosis.
To reach the diagnosis, a doctor may use several tests and exams. First, the doctor will likely take a detailed medical history and ask you to explain in as much detail as possible when symptoms started, and how or if they’ve changed. For a CIDP diagnosis, you must experience symptoms for at least 8 weeks.
In addition, a doctor may order some tests to examine other parts of your body. A nerve conduction test can help differentiate between radiculopathy (pinched nerve), myopathy (muscle disease), CIDP, and other types of neuropathy (such as diabetic neuropathy).
Likewise, a spinal fluid analysis and blood or urine tests can help a doctor rule out other possible causes for your symptoms.
Once you have a CIDP diagnosis, a doctor will recommend you to a specialist. Doctors who specialize in treating autoimmune or immune-mediated disorders have more experience with treatments and lifestyle changes that can help you slow the progression of the disease and adapt to changes more easily.
The goal of treatment for CIDP is to stop the attacks on your myelin and slow the progression of symptoms. To do this, the first line of treatment is often corticosteroids like prednisone (Deltasone or Prednicort).
Corticosteroids reduce inflammation, so they can help prevent additional demyelination and help improve symptoms. They are inexpensive and usually given intravenously. However, side effects can limit long-term use.
Other treatments include:
- Plasma exchange or plasmapheresis: This is a process by which some of the blood is removed and the blood cells are returned without certain harmful antibodies in the plasma.
- Intravenous immunoglobulin (IVIg) injections: IVIg contains naturally occurring antibodies donated by healthy volunteers. It’s injected through a vein over several hours. It works by reducing the effect of the antibodies that are causing the problem. Newer treatments are now available with preparations of higher concentrations that can be given under the skin (subcutaneously).
- Immunosuppressant drugs: These medications are used for certain severe cases.
- Hematopoietic stem cell transplant (HSCT): HSCT is a
novel therapyfor autoimmune disorders that can lead to a long-term period with no symptoms.
Before you begin exercising, however, talk with a doctor. It’s important you adopt an exercise program that works for your fitness level. Overexerting yourself may lead to muscle damage. This can slow recovery and worsen the symptoms of CIDP.
Each person living with CIDP has a different outlook. Life with this disorder varies widely from person to person. Some people will experience a spontaneous recovery and only show symptoms of the disorder from time to time. Others may experience periods of partial recovery but experience a slow, steady progression of symptoms.
The best way to improve your outlook is to get a diagnosis early and start treatment right away. CIDP can be hard to diagnose. That makes timely treatment a challenge. The sooner you can start treatment, the more likely you are to prevent damage to the nerves.
CIDP is a neurological disorder caused by inflammation of nerves throughout the body. Myelin, the protective coating surrounding nerves and fibers, is damaged in the process. This leads to symptoms such as tingling sensations in your feet and hands, as well as muscle weakness.
Because CIDP is a rare condition and can be hard to diagnose, it’s important that you talk with a doctor as soon as possible if you experience symptoms or have one of the common risk factors, such as a history of GBS. Early detection will allow you to receive the proper treatments and prevent further nerve damage.