What is chronic inflammatory demyelinating polyneuropathy?
Chronic demyelinating polyneuropathy (CIDP) is a neurological disorder that causes nerve swelling or inflammation. This inflammation destroys the protective coating that is wrapped around nerves and fibers. Myelin is the name of this fatty coating. As the myelin is destroyed, 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. In other words, the disease is long term, and once you develop it, you’ll likely live with symptoms and complications of the disorder for the remainder of your life.
CIDP, like the other inflammatory disorders that are similar to it, 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 your doctor determine which is affecting your body.
What are the symptoms?
Symptoms of CIDP include:
- slowed nerve response
- symmetrical symptoms
- sensory changes
- loss of reflexes
- slow development of symptoms over the long term
Slowed nerve response
As the myelin is destroyed and lost, the electrical impulses between your brain and nerves will slow or get lost altogether. At first, the damage may be so minor you have a hard time noticing a difference. Over time, however, the slow response will be quite noticeable.
Most people with CIDP will experience identical symptoms on both sides of their body. Instead of experiencing tingling in just one hand, you’ll likely experience it in both and at the same 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.
Loss of reflexes
Muscles may not respond as quickly as they once did, and you may notice slight muscle weakness.
Long, slow development of symptoms
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.
What causes CIDP?
Doctors and researchers aren’t clear what causes CIDP, but they do know it’s the result of an abnormal immune response. The immune system overreacts to a normal, healthy part of the body. It treats the myelin like invading bacteria or viruses, and destroys it. For that reason, CIDP is classified as an autoimmune disease.
CIDP vs. Guillain-Barré Syndrome
CIDP is the chronic form of Guillain-Barré Syndrome (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. Both conditions develop symptoms 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 damage your central nervous system. Neither affect your mental cognition either.
Unlike CIDP, the symptoms of GBS show up quickly and soon reach emergency 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 5 percent of people with GBS will experience symptoms again.
Most people who are diagnosed with GBS 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. This is not the case with CIDP.
CIDP vs. multiple sclerosis (MS)
Like CIDP, multiple sclerosis (MS) destroys the myelin coating around nerves. MS can also be progressive. The disease has a gradual progression that makes symptoms worse over time. Some people may experience periods of stability followed by periods of relapse.
Unlike CIDP, people with MS develop plaques on their brain and spinal cord. These plaques prevent their nerves from properly transmitting signals from their brain through the central nervous system and to the rest of their body. Over time, MS may even begin attacking the nerves themselves. Symptoms of MS typically show up on one side of the body at a time, not in a symmetrical pattern. The affected area and the severity of symptoms depends greatly on which nerves MS attacks.
How is it diagnosed?
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, your doctor may use several tests and exams. First, your 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 eight weeks.
In addition, your doctor may order some tests to examine other parts of your body. A nerve conduction test can let your doctor see how quickly nerve impulses move through your body. This reading can help in the future to determine if your impulses are improving or growing worse.
Likewise, a spinal fluid analysis and blood or urine tests can help your doctor rule out other possible causes for your symptoms.
How is it treated?
Once you have a CIDP diagnosis, your 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 Prednicot).
Other treatments include:
- plasma exchange
- intravenous immunoglobulin injections
- immunosuppressant drugs
- a stem cell transplant
CIDP and exercise
Research shows that people with CIDP benefit from aerobic exercise training and resistance exercise training. Both forms of exercise increase lung capacity and muscle strength. Building muscle strength and endurance can help reduce the effects of CIDP’s progressive muscle destruction.
Before you begin exercising, however, talk with your 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 exacerbate symptoms of CIDP.
What’s the outlook?
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 maintain 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 quickly finding a treatment a challenge. The sooner you can start treatment, the more likely you are to prevent damage to nerves.