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 Chronic inflammatory demyelinating polyradiculo neuropathy
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C.I.D.P

A feeling of numbness; weakness is  likely to be CIDP.  Chronic inflammatory demyelinating polyradiculo neuropathy is an immune-mediated Polyneuropathy  (inflammatory) that affects the nerves. CIDP symptoms are a slowly progressive, with numbness & tingling.  Weakness starts in the legs, or in arms. CIDP causes difficulty to walk or go upstairs.  There is some spinal cord involvement.  Occasionally, cranial nerves are involved, symptoms range from visual perception difficulties, double vision, numbness involving the face, hearing disorders. Most people believe that their knee, ankles or hip joints are a problem.  Muscle and spinal involvement is frequent in CIDP. Brain involvement in CIDP is misdiagnosed as MS. The involvement can be asymmetric form of polyneuropathy just involving one side of the body.

CIDP patient uses their hands to pull them as they are going upstairs or when trying to stand  from a chair, due to weak legs.  Burning sensations like, (Reflex Sympathetic Dystrophy.Complex regional pain syndrome) are more likely to be CIDP. (TIPs for patients)

Diabetic neuropathy is mostly CIDP. The spinal tap may show a rise in the protein level of the spinal fluid. Electromyography with nerve conduction studies may show slowing ofEMG/NCV. This nerve study will be normal when  the small fibers (autonomic nerves) are involved. Autonomic involvement cause feelings of (Pain and burning). The course of CIDP is remitting relapsing, it gets better and then worse again. Rarely the attacks come once a month, or couple of months apart."  A normal EMG/NCV does not rule out CIDP. As small fiber neuropathy and proximal CIDP will both have a normal EMG/NCV.

Just remember that diabetics have more CIDP and it responds to IVIg. This can start in the arms or it can start in the legs and go up. Some times it can be only on one side. The general rule is if its weak, its numb then its likely to be CIDP.

 

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