chronic inflammatory demylinating polyneuropathy

Tingling numbness in the toes can be Chronic Inflammatory Demyelinating Polyneuropathy . Diabetics have a higher incidence of CIDP. A super expert medical professional can diagnose CIDP on the first visit without any electro-diagnostic help, read our diagnosis page to find out which is the best test.

Any polyneuropathy is more likely to be CIDP. Chronic inflammatory demyelinating polyradiculo neuropathy is an immune-mediated Polyneuropathy (inflammatory) that affects the nerves. The symptoms are a slowly progressive, numbness and tingling starts in the feet, and then involves legs and hands. Sufferer notices weakness in the legs, later in the arms. Some complain of inability to walk or maintain balance in the dark. There is frequently some spinal cord involvement. Occasionally, cranial nerves are involved, symptoms range from visual perception difficulties, double vision, numbness involving the face, hearing disorders. Cognitive skills are not affected by CIDP. Most people believe that their knee, ankles or hip joints are a problem. Muscle and spinal involvement is frequent in CIDP. Brain involvement in CIDP is misdiagnosed as MS.

A CIDP patient uses the hands to go upstairs or rise from the squatting position, these are signs of legs becoming weaker. Some have difficulty to maintain their blood pressure, burning sensations like, (Reflex Sympathetic Dystrophy. Complex regional pain syndrome) are more likely to be CIDP.

Diabetic neuropathy is more likely to be CIDP. The spinal tap may show a rise in the protein level of the spinal fluid. Electromyography with nerve conduction studies may show slowing of EMG/NCV. This nerve study will be normal when the small fibers (autonomic nerves) are involved. Autonomic involvement cause feelings of (Pain and burning). The course of CIDP is remitting relapsing, it gets better and then worse again. Rarely the attacks come once a month, or couple of months apart." Dr King Engle speaking at CIDPUSA meeting said a normal EMG/NCV does not rule out CIDP.

CIDP is misdiagnosed as ALS. Due to a mix of upper and lower motor neuron lesions (brain, spinal-cord + peripheral nerve). M.M.F. (Multifocal Motor Neuropathy) also looks like ALS has no sensory involvement. Autoimmune ALS will have sensory changes and I call this a CIDP variant. Thus a false diagnose of ALS can be made. Dr King Engle in Los Angles has helped such patients who came in wheelchairs and in two months were walking. Untreated CIDP can turn into ALS. (ALS is a CIDP spectrum disorder)

Current standards to diagnose CIDP do not recommend a nerve biopsy: As the skip lesions of CIDP may or may not be seen in Sural nerve biopsy. After biopsy the patient may have a sensory deficit. Which may be worse then the original disease. I have seen people who are worse off due to nerve biopsy. Dr. Katz in San Francisco has said that Leprosy may be the only reason to do a nerve biopsy.

Finding of inflammation in the nerve biopsy, is rare, definitely will confirm the diagnosis of CIDP. However, the absence of inflammation does not rule out CIDP. Findings of demyelination (loss of myelin around the nerve) on the nerve biopsy can be used to confirm the clinical presentation and suggest a diagnosis of CIDP. I find the nerve biopsy unnecessary.

Please read http://www.cidpusa.org for detailed information that you will not get from anywhere in the world.