History, Diagnosis, and Management of Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Dyck, Peter James; Tracy, Jennifer A.

doi:10.1016/j.mayocp.2018.03.026

Cited by 92 publications

(109 citation statements)

References 70 publications

(55 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CIDP is regarded as a disorder with chronic or relapsing‐remitting inflammation of peripheral nerves that requires immune‐modulating treatment during active disease to prevent secondary axonal nerve damage and related permanent disability . The current study indicates that a later diagnosis may be related to a more protracted disease course requiring prolonged treatment, and more extensive residual neurological complaints and disability.…”

Section: Discussionmentioning

confidence: 71%

Clinical factors, diagnostic delay, and residual deficits in chronic inflammatory demyelinating polyradiculoneuropathy

Bunschoten

Blomkwist-Markens²,

Horemans³

et al. 2019

J Peripheral Nervous Sys

View full text Add to dashboard Cite

Management of patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is complicated by the challenging diagnosis, monitoring of disease activity, and treatment response. Real world data about the current practice of care in CIDP are rare, but important to improve clinical guidelines. In this study, we determined the current practice of diagnosis and treatment in relation to the clinical outcome of patients with CIDP in a cross‐sectional study in The Netherlands. All patients registered at the Dutch neuromuscular patient organization and patients at the Erasmus Medical Center were approached. CIDP diagnosis was confirmed by using patient files and expert consensus. The response rate was 137/197 (70%) and the diagnosis CIDP was confirmed in 112 patients. The time from onset of symptoms until CIDP diagnosis was median 5 months and > 12 months in 26% of the patients. Patients with a late diagnosis (>5 months) compared to patients with an early diagnosis (≤5 months) more frequently had another initial diagnosis (P < .001), multifocal abnormalities (P = .011), final diagnosis made in university hospitals (P = .001), and more (residual) complaints, also illustrated via two patient reported, validated clinical outcome measures. Although 97% of patients received treatment, 88% reported (residual) neurological symptoms and deficits. CIDP diagnosis is often delayed, especially in patients with atypical CIDP variants. Diagnostic delay may result in delayed initiation of treatment. A more rapid and accurate diagnosis of CIDP may prevent or at least reduce residual neurological deficits and accompanying disability in CIDP.

show abstract

Section: Discussionmentioning

confidence: 71%

Clinical factors, diagnostic delay, and residual deficits in chronic inflammatory demyelinating polyradiculoneuropathy

Bunschoten

Blomkwist-Markens²,

Horemans³

et al. 2019

J Peripheral Nervous Sys

View full text Add to dashboard Cite

show abstract

“…Степень выраженности неврологического дефицита может варьировать от легкой до тяжелой. Несмотря на то что одним из критериев установления диагноза служит временной фактор -прогрессирование симптоматики в течение минимум 8 недель, до 16% случаев заболевания приходится на дебют с острым началом, имитирующий синдром Гийена -Барре [1,2,8].…”

Section: классификация и краткое описание форм хронической воспалителunclassified

“…Очевидно, что необходимость грамотной и своевременной диагностики тесно сопряжена с наличием эффективной патогенетической терапии, определяющей прогноз и степень инвалидизации пациента. Х роническая воспалительная демиелинизирующая полинейропатия (ХВДП) -приобретенное аутоиммунное заболевание периферической нервной системы, характеризующееся ремиттирующим, прогрессирующим или стационарным течением на протяжении более 8 недель, наличием электрофизиологических или патоморфологических признаков демиелинизации периферических нервов, а также ответом на иммуносупрессивную и/или иммуномодулирующую терапию [1,2].…”

unclassified

Clinical heterogeneity of chronic inflammatory demyelinating polyneuropathy: diagnostic challenges

2020

View full text Add to dashboard Cite

Сhronic inflammatory demyelinating polyneuropathy (CIDP) is the most prevalent acquired dysimmune neuropathy with clinical picture of symmetric motor and sensory disturbances. Since the first description of CIDP, many atypical variants have been described, which may reach up to 50% of cases. Diagnosis of atypical CIDP may be challenging due to different clinical presentation and treatment response. Current researches improve our knowledge about dysimmune neuropathies and highlight the importance of its classification. Nowadays CIDP is considered as a spectrum of disorders rather than a separate disease entity. Up to date, more than 15 diagnostic criteria have been proposed reflecting the complexity of СIDP diagnosis. Many polyneuropathies may mimic CIDP, therefore CIDP is frequently a diagnosis of exclusion. The key diagnostic instrument is electroneuromyography; however, the issues related to results misinterpretation and some technical aspects are the most important in CIDP misdiagnosis. Supportive instrumental and laboratory methods have variable sensitivity and specificity, making challenging CIDP diagnosis, especially its atypical forms. The importance of an early and accurate diagnosis of CIDP is supported by an effective pathogenic treatment, which affects the patient's prognosis and level of disability.

show abstract

“…В литературе особое внимание уделяется ошибочной диагностике ХВДП из-за неверной интерпретации электрофизиологических данных [50,51]. Чаще всего рассматриваются следующие ошибки: 1) значительное аксональное поражение длинных нервов с умеренным снижением СРВ, принимаемое за демиелинизацию; 2) предпочтительный выбор глубокого малоберцового нерва для диагностики полиневрального поражения, в то время как некоторые особенности (в частности, наличие добавочного малоберцового нерва или анатомический вариант расположения короткого разгибателя мышц стопы) могут привести к получению ложноположительных результатов ЭМГ; 3) БП или локальное замедление проведения в типичных местах компрессии нервов, интерпретируемых как признаки демиелинизирующей полинейропатии; 4) незначительное снижение СРВ и выявление БП при болезни мотонейрона.…”

Section: лекции и обзорыunclassified

Conduction block as an electrophysiological phenomenon: a review of the literature

Никитин

Муртазина

Дружинин

2019

Neuromuscular Diseases

View full text Add to dashboard Cite

Evaluation and interpretation of electrophysiological phenomena often plays an important role in the diagnosis of neuromuscular diseases. Motor nerve conduction block is a reduction of either amplitude or area of the compound motor action potential elicited by proximal to distal motor nerve stimulation. Today, the value of conduction block in the diagnosis of demyelinating and axonal neuropathies, as well as the diagnostic criteria for these disorders, are still under discussion.Objective of the review of the literature is to highlight the value of conduction block as an electrophysiological phenomenon in the light of clinical manifestations. There is no consensus in the literature which motor response parameters should be used as partial conduction block criteria. The diversity of pathogenic forms in which conduction block can be registered does not allow to consider the phenomenon as a sign of only demyelinating lesions, and the term conduction block should be considered as a pure electrophysiological phenomenon. Different pathophysiological mechanisms of conduction block formation should be studied separately within each nosology. Conduction block detection does not allow to specify a particular diagnosis, however, in conjunction with clinical and anamnestic data, it may be the main argument in the diagnosis of a number of peripheral nerves diseases.

show abstract

History, Diagnosis, and Management of Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Cited by 92 publications

References 70 publications

Clinical factors, diagnostic delay, and residual deficits in chronic inflammatory demyelinating polyradiculoneuropathy

Clinical factors, diagnostic delay, and residual deficits in chronic inflammatory demyelinating polyradiculoneuropathy

Clinical heterogeneity of chronic inflammatory demyelinating polyneuropathy: diagnostic challenges

Conduction block as an electrophysiological phenomenon: a review of the literature

Contact Info

Product

Resources

About