Prognosis of neuropathy
Acquired, immune-mediated polyradiculoneuropathy It can present in many different forms, disorder with a wide range of clinical expression ranging from sudden onset to a progressive or relapsing-remitting course Diagnosis is based on clinical symptoms and signs, electrodiagnostic studies, CSF examination, and other laboratory tests CIDP: Clinical ManifestationsDemyelination which causes weakness, numbness pain stiffness.May be detected on nerve conduction studies or nerve biopsy Multifocal demyelination is a diagnostic hallmark of CIDP, but distribution of demyelinative lesions varies among patients. EMG/NCV can be normal in small fiber CIDP or autonomic CIDP.
*Weaknes Characteristically, involves both shoulder and hand muscles Typically symmetric, but can begin asymmetrically. CIDP can affect one side of the body or one limb.Sensory symptoms of tingling, numbness, pain are common but motor symptoms of weakness, fatigue, tiredness, stiffness usually predominate Autonomic system dysfunction do occur consisting of dysautonomia. May consisit of cardiac rhythm problems, diarrhea, constipation, dizziness on standing up, burning type feeling, feeling of swelling. Increased sweating which could be just on one side of the body. Loss of consciousness while standing. This can be reproduced with tilt table testing.Slow progressive course is seen in approximately 2/3 of casesChildren usually have a more quick precipitous onset of symptoms Relapsing course with partial or complete recovery between recurrences is seen in approximately 1/3 of casesPeriods of worsening and improvement usually last weeks or months Patients with a younger age of onset are said to have a higher frequency of relapsing course
CIDP: Incidence In one study, prevalence was estimated to range from 1-7.7 per 100,000 These are likely underestimates, since the criteria to select cases were strict .CIDP accounted for 13% of patients seen in one neuromuscular center Incidence increases with increasing age Children are rarely affected Continue to next page of Handbook of polyneuropathy