What is CIDP?

 

Symptoms

The severity of CIDP is extremely variable and the symptoms you experience may vary considerably from those suffered by others. Initially your symptoms may be vague and confusing to both yourself and to your doctor. Subjective symptoms such as fatigue and sensory disturbance are difficult to communicate. In the early stages it may be difficult for you to persuade your doctor that there is anything physically wrong.

Early symptoms usually include either tingling (pins and needles) or loss of feeling (numbness) beginning in the toes and fingers, or weakness, so that legs feel heavy and wooden, arms feel limp and hands cannot grip or turn things properly. These symptoms may remain mild and result in only minor disruption to normal life. Alternatively they may become progressively and gradually worse over a period of several weeks, months or even years - sometimes, but very rarely, to the extent that the person is bed bound and has profound weakness of the arms.

CIDP usually presents with both weakness and sensory (meaning altered sensation) symptoms, sometimes with weakness alone and rarely with sensory symptoms alone. The arms and legs are usually affected together, the legs more than the arms. Prickling and tingling sensations in the extremities are common and may be painful. Aching pain in the muscles also occurs. Tendon reflexes are usually lost. As the disease becomes more severe, a tremor may develop, usually in the upper limbs. Very rarely facial weakness may develop.

Diagnosis

CIDP can be difficult to diagnose as there is no conclusive diagnostic test for it. The history of symptoms is often vague with varying signs that could be symptoms of a number of conditions. Therefore a long period of time may elapse before a suggestion of CIDP is made.

CIDP is closely related to Guillain-Barré Syndrome (GBS), which is also due to inflammation of the peripheral nerves. Symptoms experienced by those with this condition are similar, but GBS is a more acute condition in which symptoms appear rapidly over a period of days or a few weeks. GBS patients usually make a spontaneous recovery over a period of weeks or months and the symptoms rarely re-occur.

CIDP is a chronic condition and is only distinguished from GBS by virtue of its pattern of progression. In GBS the low point is reached within four weeks whereas in CIDP the initial progressive phase lasts longer, usually much longer. Some CIDP patients are initially diagnosed as having GBS. Only when the deterioration continues over an extended period, or when one or more relapses occur after a period of improvement, is the illness reclassified as CIDP.

The diagnosis is made primarily on clinical grounds not laboratory tests. This means that your doctor has to rely on your history and his clinical examination fitting into the pattern of CIDP. He will particularly want to know of any recent possible toxin exposure (insecticides, solvents), medication, alcohol intake, tick bites, family history of nerve disease, or symptoms of any coincidental illness, such as diabetes or arthritis. Any of these may lead to a different diagnosis.