Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Shije, Jeffrey; Brannagan, Thomas H.

doi:10.1055/s-0039-1693008

Cited by 6 publications

(5 citation statements)

References 157 publications

(151 reference statements)

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“…The progressive phase lasted more than 3 months. Furthermore, this patient responded to corticosteroid treatment, one of the characteristics of CIDP ( 29 ). Therefore, there was sufficient evidence to confirm a CIDP diagnosis for the patient.…”

Section: Discussionmentioning

confidence: 82%

Beneficial effects and safety of traditional Chinese medicine for chronic inflammatory demyelinating polyradiculoneuropathy: A case report and literature review

Xie¹,

Li²,

Xie³

et al. 2023

Front. Neurol.

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Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated neuropathy. First-line treatments for CIDP include corticosteroids, intravenous immunoglobulin, and plasma exchange. However, the application is always limited by high costs, effectiveness, and adverse events. This study investigated a new potentially effective and safe therapeutic treatment to alleviate CIDP symptoms and improve the quality of life. In the present case, a 47-year-old rural woman presented with weakness and numbness of progressive extremities. She was diagnosed with CIDP based on abnormal cerebrospinal fluid and electromyography. The patient was treated with intravenous dexamethasone for 1 week and with Huangqi-Guizhi-Wuwu and Bu-Yang-Huan-Wu decoctions for 90 days. Surprisingly, after the treatment, the weakness and numbness were eliminated, and the quality of life improved. The varying INCAT, MRC, and BI scores also reflected the treatment effects. After 8 months of discharge, the symptoms did not relapse during the follow-up. We also searched “traditional Chinese medicine (TCM)” and “CIDP” in PubMed, EMBASE, the Web of Science, the Cochrane Library, the Chinese National Knowledge Infrastructure Databases, Wanfang Data, and the Chongqing Chinese Science and Technology Periodical Database. Finally, only ten studies were included in the literature review. Three studies were randomized controlled trials, and seven were case reports or case series. There were 419 CIDP patients, but all study sites were in China. Nine TCM formulas involving 44 herbs were reported, with Huang Qi (Astragalus membranaceus) being the most important herb. In conclusion, the case and literature demonstrated that TCM treatment might be a more effective, low-cost, and safe option for treating CIDP. Although these preliminary findings are promising, a larger sample size and higher-quality randomized clinical trials are urgently required to confirm our findings.

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Section: Discussionmentioning

confidence: 82%

Beneficial effects and safety of traditional Chinese medicine for chronic inflammatory demyelinating polyradiculoneuropathy: A case report and literature review

Xie¹,

Li²,

Xie³

et al. 2023

Front. Neurol.

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“…CIDP is an acquired demyelinating disease involving the peripheral nerves and is seen as a chronic counterpart to AIDP. 34 Differentiation from AIDP is important as CIDP has a satisfactory treatment response to corticosteroids, immunomodulators, intravenous immunoglobulin (IVIG), and plasma exchange. 35 While usually a clinical diagnosis, MRI can be differentiating.…”

Section: Methodsmentioning

confidence: 99%

“…35 While usually a clinical diagnosis, MRI can be differentiating. 34 Acute phase imaging may demonstrate diffuse enhancement and hyperintense T2-weighted signal amongst intra-and extradural spinal nerves and branches (Figure 5); chronic phase imaging may show atrophy and fatty involution of the affected muscle groups. 36 Glial fibrillary acidic protein astrocytopathy.…”

Section: Methodsmentioning

confidence: 99%

Autoimmune diseases of the spine and spinal cord

et al. 2023

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Magnetic resonance imaging (MRI) and clinicopathological tools have led to the identification of a wide spectrum of autoimmune entities that involve the spine. A clearer understanding of the unique imaging features of these disorders, along with their clinical presentations, will prove invaluable to clinicians and potentially limit the need for more invasive procedures such as tissue biopsies. Here, we review various autoimmune diseases affecting the spine and highlight salient imaging features that distinguish them radiologically from other disease entities.

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“…Methotrexate was ineffective in a survey where intravenous immunoglobulin or corticosteroids were administrated as maintenance therapy [45]. The usual dose of intravenous immunoglobulin is 2 g/kg bodyweight for 2-5 days.…”

Section: Treatmentmentioning

confidence: 99%

Chronic Inflammatory Demyelinating Polyneuropathy and Evaluation of the Visual Evoked Potentials: A Review of the Literature

Tsoumanis,

Kitsouli,

Stefanou

et al. 2023

Medicina

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Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare autoimmune disorder characterised by the progressive demyelination of peripheral nerves, resulting in motor and sensory deficits. While much research has focused on clinical and electrophysiological aspects of CIDP, there is an emerging interest in exploring its impact on the visual system through visual evoked potentials (VEPs). This comprehensive review synthesises existing literature on VEP findings in CIDP patients, shedding light on their potential diagnostic and prognostic value. The review thoroughly examines studies spanning the last two decades, exploring VEP abnormalities in CIDP patients. Notably, VEP studies have consistently revealed prolonged latencies and reduced amplitudes in CIDP patients compared to healthy controls. These alterations in VEP parameters suggest that the demyelinating process extends beyond the peripheral nervous system to affect the central nervous system, particularly the optic nerve and its connections. The correlation between VEP abnormalities and clinical manifestations of CIDP, such as visual impairment and sensory deficits, underscores the clinical relevance of VEP assessment in CIDP management. Furthermore, this review addresses the potential utility of VEPs in aiding CIDP diagnosis and monitoring disease progression. VEP abnormalities may serve as valuable biomarkers for disease activity, helping clinicians make timely therapeutic decisions. Moreover, this review discusses the limitations and challenges associated with VEP assessment in CIDP, including variability in recording techniques and the need for standardised protocols. In conclusion, this review highlights the evolving role of VEPs as a non-invasive tool in CIDP evaluation. The consistent VEP abnormalities observed in CIDP patients suggest the involvement of the central nervous system in this demyelinating disorder. As our understanding of CIDP and its pathophysiology continues to evolve, further research in this area may lead to improved diagnostic accuracy and monitoring strategies, ultimately enhancing the clinical management of CIDP patients.

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Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Cited by 6 publications

References 157 publications

Beneficial effects and safety of traditional Chinese medicine for chronic inflammatory demyelinating polyradiculoneuropathy: A case report and literature review

Beneficial effects and safety of traditional Chinese medicine for chronic inflammatory demyelinating polyradiculoneuropathy: A case report and literature review

Autoimmune diseases of the spine and spinal cord

Chronic Inflammatory Demyelinating Polyneuropathy and Evaluation of the Visual Evoked Potentials: A Review of the Literature

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