Expert Clinical Perspectives: Diagnosis of chronic inflammatory demyelinating polyneuropathy-Article

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Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic immune-mediated peripheral form of polyneuropathy. The diagnosis of CIDP can be challenging as there are no reliable diagnostic biomarkers available. Early recognition of the disease is important, as is avoiding misdiagnosis and overtreatment. The European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) published diagnostic criteria in 2021 that provide clinicians with a resource to interpret data collected during the evaluation of patients with possible CIDP. Electrophysiological findings, including motor distal latency prolongation, slowed motor conduction velocity, motor conduction block, and absent F-waves, can support the diagnosis of CIDP. However, interpretation of these findings should be cautious, as they can also be seen in other conditions. It is important to consider alternative explanations and conduct additional testing when necessary, such as examining cerebrospinal fluid (CSF) for protein levels, performing imaging studies, and conducting nerve biopsies. CIDP variants, such as distal CIDP and multifocal CIDP, can be diagnostically challenging and often require additional investigation. Misdiagnosis of CIDP is common, with many patients receiving immunotherapy for conditions they do not have. To monitor treatment response, objective measures of disability and strength impairment should be used rather than relying on subjective symptoms such as pain and fatigue. The accurate and rapid diagnosis of CIDP remains challenging, but utilizing the EAN/PNS diagnostic criteria and objective outcome measures can help improve diagnostic accuracy and treatment decisions.

Keywords

Chronic inflammatory demyelinating polyneuropathy

CIDP

immune-mediated peripheral form of polyneuropathy

diagnostic biomarkers

early recognition

misdiagnosis

electrophysiological findings

cerebrospinal fluid

CIDP variants

objective measures

cidp

Chronic Inflammatory Demyelinating Polyneuropathy