Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare neurological disease that damages and destroys the nerves in a person’s body.
CIDP affects a person’s ability to move, especially their arms and legs, as well as their sensory functions, leading to tingling, numbness, and diminished sensation.
This article discusses CIDP in more detail, including causes, diagnosis, symptoms, and treatment.
CIDP fast facts
- The average age of onset of CIDP is 50 years old.
- Males are twice as likely as females to have the condition.
- Symptoms may start with a change in walking or tingling and numbness in the hands and feet.
Although experts do not know the exact cause of CIDP, they believe it is an autoimmune disorder where the body’s defense systems attack healthy tissues.
In the case of CIDP, these healthy tissues are the myelin sheaths that protect the peripheral nerves and enable the nervous system to transmit signals more quickly. Nerve inflammation may cause or be caused by the myelin damage.
The disorder is rare, occurring in around 5–7 people per 100,000 in the United States.
While the disease has some similarities to other neurological disorders, such as Guillain-Barré syndrome (GBS) and multiple sclerosis (MS), there are several differences in onset, symptoms, and treatments.
The main difference is that GBS is a single event that starts suddenly and worsens rapidly, but CIDP is chronic, can involve constant symptoms, or may have flares. A person with CIDP usually has symptoms that may continue for
Another difference is that GBS is an acute disorder that might not recur, while CIDP symptoms may be ongoing or recurrent. Some doctors consider CIDP a chronic form of GBS.
Both MS and CIDP are chronic inflammatory demyelinating conditions that cause recurrent or ongoing symptoms. However, MS causes demyelination of the central nervous system — the brain, spinal cord, and optic nerves — while CIDP causes demyelination of the peripheral nervous system.
CIDP is rare, so doctors usually initially consider more common neurological conditions before diagnosing CIDP.
As the symptoms are often progressive, a doctor may need to monitor an individual before being clear about the diagnosis.
A doctor will begin by taking a medical history and asking the person about symptoms. Some signs that may indicate CIDP include the absence of reflexes, diminished sensation, and weakness in the arms and legs.
After considering a person’s symptoms, a doctor will likely order a range of tests to rule out other similar disorders. For example, they may recommend a lumbar puncture to test spinal fluid for the presence of inflammatory cells, such as white blood cells. Myasthenia gravis, meningitis, and nervous system cancer can also cause a range of symptoms that are similar to CIDP.
A doctor will order tests to measure how well the person’s nerves are conducting electrical signals and how well the muscles are responding to electrical signals. These tests include nerve conduction testing and electromyography.
People respond differently to CIDP treatments. Many people experience partial or complete resolution of symptoms, but some may not have any improvement.
Symptoms associated with CIDP can recur as flares or episodes, may be progressive during an episode, or may remain stable. Some of the condition’s potential symptoms include:
- clumsiness
- dysphagia or difficulty swallowing
- double vision
- foot drop
- numbness in the hands or feet
- tingling or pain in the extremities
- loss of sensation in the arms or legs
- unexplained fatigue
- shortness of breath
The condition’s symptoms tend to occur on both sides of the body — for example, in both legs. Some people may only notice changes in sensory function, such as tingling and numbness, without experiencing changes in their walking or movement. These symptoms usually develop gradually and progress over days or sometimes weeks.
Treatment for CIDP involves aiming to reduce the inflammation and demyelination that cause the nerve-related symptoms.
Although there is no cure for the condition, medications that help regulate the immune system can help reduce myelin and nerve inflammation. The Food and Drug Administration (FDA) has approved two drugs to treat CIDP: Gamunex and Privigen.
These drugs decrease the immune system activity that causes nerve-related symptoms. Both are in the IVIg class, meaning that immunoglobulins are injected intravenously over several hours. It works by reducing the effect of the antibodies causing the condition.
Both Gamunex and Privigen contain antibodies — immunoglobulins — that help prevent other immunoglobulins from damaging myelin and nerves.
Another effective option to treat CIDP is plasma exchange or plasmapheresis.
This procedure involves removing blood from an individual and separating the red blood cells and components, such as antibodies, from the plasma that contributes to CIDP. Donor plasma is then added to the blood and transfused back into the individual.
Newer treatments with preparations of higher concentrations of immunoglobulins are available. This can be given under the skin — subcutaneously.
While these medications can help to reduce inflammation in CIDP, they do not cure it.
Another new treatment option is
A doctor
These drugs include:
- azathioprine
- cyclophosphamide
- cyclosporine
- methotrexate
- mycophenolate
In addition to the medications that treat inflammation, there are also treatments that can help reduce the uncomfortable sensory sentence of CIDP. They include:
- carbamazepine
- gabapentin
- amitryptiline
- pregabalin
- duloxetine
Some people may have trouble breathing, so respiratory support may be necessary until they regain the strength of their respiratory muscles.
Sometimes, doctors will recommend an anti-inflammatory diet for those with CIDP to help reduce the recurrence of inflammation. However, diet alone is not sufficient to substitute for the medications listed above.
An anti-inflammatory diet has many of the same characteristics as most healthy diets, so a person should avoid:
- high sodium foods
- high sugar foods
- processed foods
- saturated fats
- trans fats
A person with CIDP may benefit from a predominantly plant-based diet filled with vitamin-rich fruits and vegetables. Other beneficial foods include lean meats and fatty, low mercury fish, such as salmon.
Dietary recommendations may vary according to an individual’s additional health conditions or unique dietary preferences.
A 2018 study found that the overall response rate among people with CIDP who received conventional first-line immunotherapies was
However, many people with CIDP have some degree of physical disability, and some of these will require assistive devices, such as canes, walkers, or wheelchairs.
CIDP is a rare disease that affects a person’s mobility and sensory functions, causing symptoms such as tingling, numbness, and loss of sensation in the limbs. The cause is still unclear, but experts believe it is related to the immune system’s attack on the myelin sheaths protecting the peripheral nervous system.
CIDP shares some similarities to other neurological disorders, such as GBS and MS. It is important to get the correct diagnosis to receive proper treatments. Many types of treatments are available, some of which can lead to long-term remission. However, CIDP does not have a cure to date, and a person with this condition may expect to experience relapses and live with some degree of physical disability.