CIDP – Causes, Symptoms, and Diagnosis
Chronic inflammatory demyelinating polyneuropathy, or CIDP, is a rare health condition related to the nervous system. The complication compels the body to attack the myelin sheaths, which are the fatty coverings on the fibers that insulate and protect the nerves. Usually, CIDP is assumed to be associated with the more common Guillain-Barre syndrome (GBS) because some of the symptoms are similar.
What is CIDP and its causes?
CIDP starts with the immune system in the body attacking the myelin sheaths, a protective layer around the nerve cells. This causes inflammation in the roots of the nerves and the nerves themselves, further leading to the breakdown of the myelin sheaths. This process damages the nerve fibers, slowing down their ability to send signals to the brain.
However, what triggers the immune system to act this way and attack the nerves is still unknown. Also, there are no specific or known risk factors that can increase the risk of a person developing CIDP. Yet, it has been observed that those who are 50 to 60 years old are usually diagnosed with CIDP. Additionally, men have a higher risk compared to women. In either case, CIDP is generally classified into three categories.
- Progressive
The symptoms become worse over time if left untreated for a long time. - Recurrent
The symptoms occur periodically in episodes. - Monophasic
The condition persists for a couple of years and never recurs.
In each of these categories, CIDP disease life expectancy is nearly the same as those who don’t have the condition. However, it is highly possible that other health conditions that occur along with CIDP and complications might bring down the quality of life of a person. This can invariably shorten life expectancy.
Symptoms of CIDP
CIDP symptoms differ based on the type of the category of the condition. This means the symptoms of CIDP will be different for progressive CIDP, recurrent CIDP, and monophasic CIDP. However, some symptoms are quite common across all the three variants. These include some of the first symptoms of CIDP: muscle weakness and numbness.
The early signs of the condition usually last for over eight weeks or more. These symptoms occur in the muscles of the following areas, generally on both sides of the body.
- Thighs
- Hips
- Upper arms
- Shoulders
- Hands
- Feet
Some of the other symptoms of CIDP include the following:
- A loss of muscle mass (also known as atrophy) in the muscles of the affected areas
- The feeling of tingling or prickling and numbness in the extremities, that is, the toes and fingers, is called paresthesia.
- Clumsiness due to lack of coordination and balance.
- A loss of mobility
- Weakening or loss of deep tendon or muscle stretch reflexes
- Feeling mild to severe neuropathic pain
Besides, one may also experience some of the uncommon yet notable symptoms of CIDP, such as difficulty in swallowing food or dysphagia and weakness in the area of the neck. Sometimes, one may also have double vision.
Most of the time, the severity of these symptoms keeps on changing with time. Sometimes, the symptoms develop pretty quickly, while other times, the onset is quite slow. Often, the symptoms come and go over time. If not diagnosed or treated on time, the condition can progress and become worse. As the condition progresses, one may start to experience irresistible nerve damage. In such situations, permanent disability is inevitable in the final stages of CIDP.
How is it diagnosed?
While it is not possible to completely cure CIDP, managing the symptoms is possible. At the least, treatment can help to slow down the progress of the disease and reduce the severity of the symptoms. Moreover, the quality of life of a person with CIDP can be improved greatly with time treatment. However, for this to be effective, it is crucial to have an early diagnosis.
However, it is quite difficult to diagnose it if a person is experiencing only the first symptoms of CIDP. This is because the condition is so rare, and the early symptoms are similar to those of other more common diseases. This is why doctors often misdiagnose CIDP with GBS. Whatever the case, a healthcare team will first recommend providing the patient’s medical history, followed by a physical examination.
Once these basic tests are done, a healthcare provider may recommend other tests to have a confirmed diagnosis of CIDP. Some of the diagnostic tests include the following.
- Blood and urine tests
These are generic tests done to rule out other suspected conditions causing the symptoms. - A nerve conduction study
This procedure is used to check whether there has been any damage to the myelin sheath in peripheral nerves. Also known as electromyogram, this test uses very low-intensity electrical currents to test the function and response of the nerves. - A lumbar puncture
A small needle is intravenously administered in the back to take a portion of cerebrospinal fluid, or CSF, which surrounds the spinal cord. The fluid is then tested to check for high levels of proteins, which are usually related to CIDP.