All about CIDP
CIDP is misdiagnosed as ALS. Due to a mix of upper and lower motor neuron lesions (brain, spinal-cord + peripheral nerve). M.M.F. (Multifocal Motor Neuropathy) also looks like ALS has no sensory involvement. Autoimmune ALS will have sensory changes and presents like Lewis Sumner. Thus a false diagnose ofALS can be made. Dr Bedouine helped such patients who came in wheelchairs and in two months were walking. Untreated CIDP can turn into ALS. (ALS is a CIDP spectrum disorder)
Motor Nerve conduction
Current standards to diagnose CIDP do not recommend a nerve biopsy: As the skip lesions of CIDP may or may not be seen in Sural nerve biopsy. After biopsy the patient may have asensory deficit. Which may be worse then the original disease. I have seen people who are worse off due to nervebiopsyFinding of inflammation in the nerve biopsy, is rare, definitely will confirm the diagnosis of CIDP. However, the absence of inflammation does not rule out CIDP. Findings of demyelination (loss of myelin around the nerve) on the nerve biopsy can be used to confirm the clinical presentation and suggest a diagnosis of CIDP. We find the nerve biopsy unnecessary.For those in whom this procedure has to be done. The best technique is described by a Austrian team. Where they only remove a 10mm piece of the Sural nerve and reattach the stumps by microsurgical repair. They claim none of their patients had any complaints of pain or sensory loss.
However Massachusetts General Hospital has come off with a novel idea of doing a skin biopsy instead of a nerve biopsy. This provides more information in small fiber neuropathies and is less invasive. In the old days GBS patients were in bed for 6 months, today patients improve in a few days, due to modern treatments.
According to Dr the best test for CIDP is to give treatment and see if the patient responds to the treatment. (This saves time and money.)
If you are following ANA guidelines you will miss most of the patients with CIDP.These guidelines are for research studies and not meant for clinical patients as diseases to not follow guidelines.
For long term treatment, (interferon, Cellcept, Cyclosporine, Steroids are only used for short term benefits best given in pulse intravenous doses. Some Centers are using Avonex, Enbrel, Remicade and Rituxan. From early reports all of these drugs works well,
novel pharmaceutical have been seen to help CIDP!
ABOUT MISDIAGNOSIS OF CIDPIn USA, we help supply FDA approved IVIg through specialized pharmacy. Delivered to your door with a nurse all insurance work done by them. Results of EMG/NCV explained
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